Pega Customer Service for Healthcare Implementation Guide · 2019-05-22 · CONTENTS Overview 11 Implementation delivery methodology 11 Initiation stage 12 Delivery stage 13 Prerequisites

Pega Customer Service for Healthcare

IMPLEMENTATION GUIDE7.31

PEGA CUSTOMER SERVICE

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DOCUMENT: Pega Customer Service for Healthcare Implementation GuideSOFTWARE VERSION: 7.31PUBLISHED: Monday, December 04, 2017

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CONTENTS

Overview 11Implementation delivery methodology 11

Initiation stage 12Delivery stage 13

Prerequisites 14Pega Customer Relationship Management for Healthcare suite application stack 15

Initiation stage 16Accessing the sample application 16Creating your application 16Enabling operator accounts 17Optional: Configuring your applications for Pega Customer Relationship Management for Healthcare 18

Adding shared rulesets 20Creating integration rulesets 21Enabling or disabling shared features 22Updating an access group to allow shared access 23

Customer sample data 24Pega Marketing sample application and data 24

Generating specification documents 25Generating the Application profile 25Generating the Application document 26Generating the Specification document 26

Delivery stage 27Defining requirements 27

Defining the case type modifications and attributes 28Updating case types 30Adding case types 31Work object prefixes and naming conventions 31Defining class group to database table mapping 33Confirming case type locking setting 33Pega Customer Service for Healthcare case types 34

Pega Customer Service for Healthcare Implementation Guide 3

Cases available from Pega Customer Service 34Cases available from Member Services 35Cases available from Provider Services 35Cases available from Clinical Interaction Manager 36

Adding important messages to case types 36Defining the data model 36

Application data model 37Defining integration 38

Mapping application data 39Defining application behavior 40

Defining interaction types, driver categories, and tasks 40Defining interaction types 41Defining Interaction Driver categories 41Defining intent tasks 41

Defining dialogs and coaching tips 42Mapping the dialogs to the flows 42Defining coaching tips 43Defining knowledge content integration 44

Defining the search behavior 44Defining the interaction goals 45Defining the call duration goal 45Defining the call verification method 46Defining application settings 47Defining customer events to track 47

Defining behavior for additional components 48Defining Pega Intelligent virtual assistant for the Facebook Messenger configuration 49Defining Pega Co-Browse configuration 50Defining the Pega Knowledge configuration 51Defining Pega Customer Decision Hub and Customer Decision Hub behavior 51Defining Pega Social 52Defining Pega Call configuration (telephony integration) 52

Planning the connectivity to your telephony infrastructure 52Planning the CSR experience 53


Defining Pega Chat requirements 54Defining the chat queues and operator skills 54Defining common phrases 55Defining web pages to push for chat 56

Defining Net Promoter Score settings 56Defining the user experience (UX) customization 57

Designing the customer composite 57Designing the portals 58

Defining the dashboard personalization 58Defining application entry point 59

Determining the application skin and styles to modify 59Designing for screen performance 60Designing web self-service 60Determining which part of the user interface to modify 61

Defining the security model and organization structure 61Authentication schemes 62Defining your authentication scheme 62Defining your authorization scheme 63

Defining access roles and privileges 63Defining your access groups 63

Defining the organization 64Defining the operator attributes 64

Defining the operator work group 64Defining the operator skills 65Defining the operator calendar 65

Defining reporting requirements 66Determining reporting architecture 66Reviewing existing reports 67Identifying key metrics 67Identifying dashboard reports 68

Building features 68Building a new application 69

Enabling automatic service case creation 69


Configuring the New menu to test an application 70Configuring application settings 70

Integrating data 72Configuring channels 74

Add Task Menu categories 75Configuring Add Task Menu categories for each channel 75Creating service cases 76Modifying service cases 77Creating an Intent Task 77

Editing service request options 78Creating Intent When rules 79Creating interaction goals 80Creating call duration goals 81Adding data sources 82

Editing data source rules 84Configuring suggested work item reviews 85Configuring common phrases 85

Adding and editing categories 85Adding and editing Common phrases 86

Adding and enabling transcript data masks 87Configuring Page push 87

Adding and editing categories 88Adding and editing URL 88

Configuring chat queues for Pega Chat 89Configuring suggested Augmented Agent AI responses 91

Configuring dialogs and coaching tips 92Creating or editing dialogs 92Creating or editing coaching tips 93

Configuring important messages 94Configuring the behavior of additional components 95

Configuring Pega Call 96Configuring Pega Co-Browse 96Configuring Pega Chat 97


Configuring voice and data transfer for Pega Call 97Enabling the Transfer tool 97Enabling the Accept button on the Review Harness 97Transfer reasons 98Setting a time limit for voice and data transfers 98

Configuring Pega Social 98Configuring Pega Knowledge 99

Linking Knowledge content articles 100Configuring Email 100

Updating an email account 101Creating an email channel from the landing page 101Setting up an email listener 101

Tablet support 102Differences between tablet and desktop portals 102Responsive UI 103Interaction class and Interaction Driver 103Rule specialization for a tablet 103

Web self-service 104Configuring anonymous customer interactions 104

Modifying the user experience 105Modifying the user interface element to change 106Implementing user interface changes to the Interaction Portal 106

Adding a new property to a section 106Adding a new section to the Interaction Portal 107Updating the Interaction Portal skin 108Configuring Interaction Portal tabs 108Launching a service case from the composite 109Logging an event during an interaction 110Changing the home page reports 111

Configuring the portal search 111Configuring the portal search for external data sources 112Configuring search for cases and work objects 112

Quality reviews and customer satisfaction surveys 113


Configuring survey rules 113Configuring survey rating categories 114Configuring survey selection 114Determining interactions to survey for customer satisfaction 115Changing Net Promoter settings 115

Customer Decision Hub 116Configuring Customer Decision Hub 117

Configuring access groups 118Configuring reports 119

Configuring the Estimated Application Savings report 119Setting up the report 119Configuring the report 120Modifying the Savings report 121Modifying the Drill-down report 121

Testing a new application 121Testing your application in the Build environment 121Testing in the Test or Production environments 123Testing in the UAT environment 124

Packaging a new application 125Merging application changes 125Packaging an application for migration 126Importing the packaged application 126Multitenancy deployment considerations 126Overriding rules to use Pega Social 127

Production maintenance and monitoring 128Business rule maintenance in the Production environment 128Application health monitoring 128Identifying and reporting issues 129

Pega Chat implementation 130Defining requirements for Pega Chat implementation 130

Defining which web pages will have chat capabilities 131Defining the chat window branding 131


Defining optional proactive chat 131Defining the chat queues and operator skills 132Defining URL mappings for chat 133Defining common phrases 134Defining optional Pega Co-Browse settings 134Defining dashboard widgets 135Defining the chat server location and communication settings 135

Building Pega Chat features 138Configuring the content security policy 138Configuring the chat server communication settings 139Configuring pre-chat questions for chat 140Branding the customer chat window 141Configuring optional proactive chat 141Configuring URL mappings for chat 142Enabling chat on your website 143Configuring co-browse in Pega Chat 145Enabling automatic Pega Chat login 145

Testing, packaging, and maintaining Pega Chat 147Synchronizing application updates with the chat server 147Monitoring chat queues 148

Monitoring chat queues from the Interaction Portal 148Monitoring chat queues from Designer Studio 148Chat queue statistics 148

Pega Social configuration 150Defining requirements for the Pega Social configuration 150

Compiling a list of business Twitter handles and Facebook business pages 151To compile a list of business Twitter handles, remember the following points 151To compile a list of Facebook business pages, remember the following points 151

Defining and registering Facebook and Twitter applications 151Defining operators, access groups, work groups, and workbaskets 153

Building Pega Social functionality 153Updating the GetOpenSocialCasesFromWorkList report definition for your application 154


Configuring social streams 154Configuring Twitter and Facebook connectors 155Configuring wrap-up reason codes for social interactions 156

Adding or modifying the wrap-up reason code - resolved, for social interactions. 156Adding or modifying the wrap-up reason code - dismissed, for social interactions. 157

Configuring social queues 157Defining topics 158Enabling customer service representatives to respond to social messages 158Authorizing customer service representatives on social channels 159

Authorizing CSRs on Twitter 159Authorizing CSRs on Facebook 160

Setting up an email account 160Enabling the social agents 160Attaching Facebook images 162Configuring the social settings 164

Monitoring Pega Social 165Monitoring connectors 165Monitoring agents 165Monitoring social channel operations performance 165


OverviewPega Customer Service for Healthcare is a packaged, scalable solution that drives healthcare customer service interactions through a process-driven approach across multiple channels to resolve issues quickly at the point of contact. Depending on which components your organization has licensed, this application includes the following components:

l Member Services

Enables healthcare organizations to service consumers of healthcare services, such as health plan members

l Provider Services

Enables healthcare organizations to service medical providers, such as physicians, practice staff, and healthcare system personnel

l Clinical Interaction Manager

Provides customer relationship manager (CRM) capabilities to clinical groups within healthcare organizations for consumer and provider medical program engagement and to service utilization management requests

Built on the Pega Platform, Pega Customer Service for Healthcare automates common service requests through intent-driven processing and anticipates customer and operator needs so that customer service representatives (CSRs) have the necessary tools to deliver personalized and responsive service. The application delivers new value from healthcare organizations’ back-end data and processing silos, provides agility to meet changing business requirements, and facilitates compliance with internal and external regulations.

Pega Customer Service for Healthcare is built on the Pega Customer Service application. It includes multiple components; some components are optional. The healthcare data model and healthcare service processes are provided for you in the Pega Customer Service for Healthcare application.

Implementation delivery methodologyIn most cases, use a scrum-based, Agile delivery model for a Pega application implementation. In the rare cases where a waterfall-based implementation methodology is better suited, use Pega’s Iterative Waterfall approach. These two implementation methodologies help break down the work into manageable components that you can deliver to production faster. The Pega delivery approach has the following primary stages:


Overview

• Initiation stage

• Delivery stage

Initiation stageIn the Initiation stage, the implementation teams build the foundation or baseline of the application and prepare for the work that is necessary to configure the first production release and subsequent extended production releases. Keep in mind that the first production release is the minimal required scope to go live into production. Other capabilities can be added as part of the extended production releases. Building a strong foundation to support expansion and reuse is key to the success of an implementation.

The Initiation stage is further organized into the following sub-stages:

Plan

Align the vision and roadmap to establish the foundation for the implementation. The Plan sub-stage includes the following tasks:

l Defining the production release milestone

l Refining scope alignment

Set up

Validate and review the Pega-provided features and capabilities to see if they meet your requirements and expectations. This sub-stage includes the following tasks:

l Establishing environments and processes

l Reviewing application feature descriptions (in Designer Studio, click Application menu > Overview)

l Reviewing Application Guides for first production release setup information (in Designer Studio, click Resources > Application Guides)

l Creating the baseline application

l Loading customer data

l Demonstrating the baseline application


Overview

l Reviewing artifacts from the solution assessment

l Reviewing business needs and outcomes

Prepare

Prepare for the delivery of Pega Customer Service for Healthcare by completing the following tasks:

l Confirming resources

l Enabling team members

l Establishing governance

At the conclusion of the Initiation stage, the scope of the work for the first production release is clearly defined. For Scrum, the scope of the work is represented in an initial backlog. For Iterative Waterfall, a specification list and schedule are prepared and finalized.

Delivery stageThe Delivery stage is dependent on the methodology selected (Scrum or Iterative Waterfall). During this stage, the delivery team designs, builds, configures, and tests the application by using the selected implementation methodology. The goal is to accomplish the tasks that are described in this document by organizing the Application Feature backlog so that the delivery team can configure the application incrementally with the result being a fully tested and performance-tuned application in production.

The Delivery stage is organized into the first production release and the extended production release types.

First production release

This release includes only the essential features that are defined during the solution proposal stage and are required for the first release into production. The first production release should be implemented in 90 days or less, depending on the scope of the essential features. This release type includes the following features:

l Core Pega-provided features

l Extended features considered essential for your business

l Key day-one integrations with your systems to get data that you require


Overview

Extended production release

This release includes the non-essential features that are defined during the solution proposal stage. The following features are implemented incrementally after the first production release:

l Non-essential Pega-provided features

l Extended features that you have identified as required for your business

This guide provides information to support both Scrum and Iterative Waterfall implementation methodologies during the first production release and the extended production release.

PrerequisitesBefore you start your Pega Customer Service for Healthcare implementation, make sure that you understand the following information:

l Support for various browser versions. Review the Platform Support Guide.

l Basic functionality of the Pega Customer Service for Healthcare application. Enroll in Pega Customer Service Foundation and Introduction to Pega Customer Service for Healthcare on the Pega Academy site.

l Telephony terminology and architecture. For an overview, watch the Understanding Telephony with Pega Call video on the Pega Call product page.

l Basic functionality of the Pega platform. Enroll in Pega Platform Fundamentals on the Pega Academy site.

l Net Promoter™ capability is part of the Pega Customer Service for Healthcare application, but its use is optional. Pega Co-Browse, Pega Knowledge, Pega Marketing, Pega Social, Pega Call, and Pega Chat are optional components that can be implemented at the same time as Pega Customer Service for Healthcare, or added to the application afterwards.


Overview

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Pega Customer Relationship Management for Healthcare suite application stack

Pega Customer Relationship Management for Healthcare includes Pega Customer Service for Healthcare and Pega Sales Automation for Healthcare. Each application requires a separate license in order to use it in your environment. If using Pega Marketing, install that application separately.

All Pega healthcare applications are built on Pega Foundation for Healthcare, which contains the healthcare data model.


Overview

Initiation stageThe Initiation stage includes the following tasks:

1. Accessing the sample application

2. Creating your application

3. Enabling operator accounts

4. Optional: Configuring your applications for Pega Customer Relationship Management for Healthcare

5. Customer sample data

6. Generating specification documents

Accessing the sample applicationPega Customer Service for Healthcare includes a sample application so that you can use it to see how your product works.

PrerequisitesYou installed sample data during installation as described in the installation guide on the Pega Customer Service for Healthcare product page.

To access the sample application:

l Log in by entering the operator with the password that you specified.

Creating your applicationThe first step in implementing Pega Customer Service for Healthcare to best meet your organization's needs is to create the application on which your extended application will be built. Use the New Application wizard to create your new application. The wizard creates the application structure for you.


Initiation stage

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When you run the New Application Wizard for Pega Customer Service for Healthcare, it creates a set of Pega-provided operators. For security purposes, these operators are disabled. To use the new application, you have to enable appropriate operators. See Enabling operator accounts.

1. Log in by entering the administrator user name with the password that you specified.

User Name: cshcsysadmin

If this is a Clinical Interaction Manager implementation, enter CimSysAdmin in the User Name field.

2. Create the application by following the steps in Creating an application with the New Application wizard.

Keep in mind your application-specific requirements.

3. Log in to your new application after you enable the appropriate operator IDs.

Note: All procedures in this guide require that you log in to your new application by entering credentials for that application, unless otherwise noted.

The New Application wizard creates the application class structure for you. You can reuse the classes and rulesets that are created by the wizard in future applications that you create. As you implement this application and future applications, you can apply class hierarchy and inheritance principles to help you decide where in the class structure to create your rules to improve the maintainability and overall efficiency of your application.

For more information, see Class layers.

Enabling operator accountsFor most operations in Pega applications, you perform actions as different roles and operators. When you run the New Application Wizard for Pega Customer Service for Healthcare, it creates a set of Pega-provided operators. For security purposes, these operators are disabled. Before you can log in and use the access rights of any operator in your new application, you must enable that operator.

For additional information, see Initial Operator IDs (Data-Admin-Operator-ID).

1. Log in as the cshcsysadmin operator with the password that you specified.

2. Click Designer Studio > Org & Security > Authentication > Operator Access.

This page lists all currently disabled operator accounts.


Initiation stage

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3. In the Disabled operators section, click the link for the Pega-provided operator that you want to enable.

4. Optional: In the Contact Information section on the Profile tab, fill out any information that your site requires.

5. On the Edit Operator ID page, on the Security tab, select the Force password change on next login check box and clear the Disable Operator check box.

6. Select Update password.

7. In the Change Operator ID Password window, enter a password that conforms to your site standards and click OK.

8. Click Save to enable the operator record and the new password, and then close the page

9. On the Organization and Security: Operator access page, repeat steps 3 through 8 for each operator that you want to enable.

Optional: Configuring your applications for Pega Customer Relationship Management for HealthcareThese procedures are required only if you will use the Pega Customer Relationship Management features to share data and service cases across the Pega Customer Service for Healthcare, Pega Sales Automation for Healthcare, and Pega Marketing applications. These procedures involve configuration across all three applications, and they include links to the other implementation guides as needed.

PrerequisitesYour Pega Customer Service for Healthcare, Pega Sales Automation for Healthcare, and Pega Marketing applications must already be created as described in Creating your application.

To configure the Pega Customer Relationship Management features, complete the following steps:

1. For environments that include both Pega Customer Service for Healthcare and Pega Sales Automation for Healthcare, complete the following steps.

a. Add the Pega Sales Automation for Healthcare implementation rulesets to your Pega Customer Service for Healthcare application, and add the Pega Customer Service for Healthcare


Initiation stage

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implementation rulesets to your Pega Sales Automation for Healthcare application. See Adding shared rulesets.

b. Create an integration ruleset for your Pega Customer Service for Healthcare and Pega Sales Automation for Healthcare applications, and then add the integration ruleset to the top of the ruleset stack for each application. See Creating integration rulesets.

c. Enable the Pega Customer Relationship Management features. See Enabling or disabling shared features.

d. In your Pega Customer Service for Healthcare application, update the operator access groups to include the CustomerService:CSRSalesAccess role that is required to access the shared features. See Updating an access group to allow shared access.

2. For environments that also include Pega Marketing, complete these additional steps.

a. Configure your Pega Customer Service for Healthcare application to support Pega Customer Decision Hub.

i. Enable Pega Customer Decision Hub. See Configuring application settings.

ii. Configure Customer Decision Hub settings. For each setting, copy the rule to the highest ruleset shared by Pega Customer Service for Healthcare and Pega Sales Automation for Healthcare, and save your changes in that ruleset. See Configuring Customer Decision Hub.

b. In Pega Marketing, configure the application to support the Pega Customer Relationship Management features. See "Configuring Pega Marketing to support the Pega Customer Relationship Management features" on the Pega Marketing Implementation Guide on the Pega Marketing product page.

c. In your Pega Sales Automation for Healthcare application, configure the integration between Pega Sales Automation for Healthcare and Pega Marketing. See "Configuring the integration between Pega Sales Automation for Healthcare and Pega Marketing" in the Pega Sales Automation for Healthcare Implementation Guide on the Pega Sales Automation for Healthcare product page.

d. In your Pega Sales Automation for Healthcare application, test the integration with Pega Marketing local campaigns. See "Testing the Pega Sales Automation for Healthcare integration with Pega Marketing local campaigns" in the Pega Sales Automation for Healthcare Implementation Guide on the Pega Sales Automation for Healthcare product page.


Initiation stage

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e. In Pega Marketing, train the adaptive model for sales offers. See "Configuring Adaptive Decision Manager for sales offers" in the Pega Marketing Implementation Guide on the Pega Marketing product page.

f. In Pega Marketing, run a Marketing campaign for batch evaluation. See "Running a marketing campaign for batch evaluation" in the Pega Marketing Implementation Guide on the Pega Marketing product page.

g. In your Pega Sales Automation for Healthcare application, test the integration with Pega Marketing next best offers. See "Testing the Pega Sales Automation for Healthcare integration with Pega Marketing next best offers" in the Pega Sales Automation for Healthcare Implementation Guide on the Pega Sales Automation for Healthcare product page.

Adding shared rulesetsNote: This procedure is required only if using the Pega Customer Relationship Management features.

To enable sharing of data between your Pega Customer Service for Healthcare and Pega Sales Automation for Healthcare applications, add the implementation rulesets from one application to the other. The implementation rulesets are created by the New Application wizard for a new application.

Add only the rulesets that you want to expose in the other application. The lead system architect (LSA) or project architect can provide guidance on what functionality is included in each ruleset.

Add these rulesets at the bottom of the ruleset stack so that you do not overwrite your application's implementation rulesets. (When you want to overwrite your application's rulesets, use an integration ruleset as described in Creating integration rulesets.

1. View the implementation rulesets created for each of your applications.

a. Log in to each of your applications in Designer Studio.

b. Click Application menu > Definition.

c. In the Application rulesets section, note the implementation rulesets created for each application.

2. Add the implementation rulesets from your Pega Sales Automation for Healthcare application to the bottom of the ruleset stack for your Pega Customer Service for Healthcare application.


Initiation stage






a. Log in to your Pega Customer Service for Healthcare application in Designer Studio.


c. In the Application rulesets section, click Add ruleset to add Pega Sales Automation for Healthcare rulesets to the bottom of the ruleset stack, and then click Save.

3. Add the implementation rulesets from your Pega Customer Service for Healthcare application to the bottom of the ruleset stack for the Pega Sales Automation for Healthcare application.

a. Log in to the Pega Sales Automation for Healthcare implementation application in Designer Studio.


c. In the Application rulesets section, click Add ruleset to add Pega Customer Service for Healthcare rulesets to the bottom of the ruleset stack, and then click Save.

Creating integration rulesetsNote: This procedure is required only if using the Pega Customer Relationship Management features.

When using a Pega Customer Relationship Management configuration that includes both Pega Customer Service for Healthcare and Pega Sales Automation for Healthcare, you must sometimes override the rules in one application to expose functionality from the other application. To support this, create an integration ruleset in both applications, and then save the override rules to the integration ruleset.

For example, if the Pega Customer Service for Healthcare application will show Pega Sales Automation for Healthcare Lead case service cases, you want the service case header and footer to look the same as the other Pega Customer Service for Healthcare services cases. In that case, save the perform harness rule for the service case into the integration ruleset for the Pega Customer Service for Healthcare application. Doing so overrides the Pega Sales Automation for Healthcare header and footer for that service case.

The applications include a sample integration ruleset that you can copy or use as a model for a new integration ruleset. The sample integration ruleset for Pega Customer Service for Healthcare is SAHCforCSHC, and the sample integration ruleset for Pega Sales Automation for Healthcare is CSHCforSAHC.

Complete the following steps to configure the integration rulesets.


Initiation stage

1. Log in to your Pega Customer Service for Healthcare application in Designer Studio.

2. Click Application menu > Definition.

3. In the Application rulesets section, click Add ruleset.

4. Type a name for the new integration ruleset that identifies its purpose. For example, MyAppCRMIntegration, where MyApp is your application prefix.

5. Click the Open icon to the right of the ruleset field.

6. Review the default Ruleset Name, Version, and Description values, and modify the values if needed.

7. Click Create and Open, and then click Save.

8. In the ruleset field, identify which version of the ruleset to use by appending the major and minor rule version to the end of the integration ruleset name in this format: :NN-NN. For example, to select the first version of the ruleset, append :01-01 to the end of the ruleset name.

9. Move the new integration ruleset to the top of the ruleset stack by dragging the number to the left of the ruleset name to the top of the stack.

10. Click Save.

11. Repeat this procedure for your Pega Sales Automation for Healthcare application.

Enabling or disabling shared featuresNote: This procedure is required only if using the Pega Customer Relationship Management features.

The value of the Boolean property IsCRMModeDeployment enables or disables the Pega Customer Relationship Management features that support shared functionality between your Pega Customer Service for Healthcare and Pega Sales Automation for Healthcare applications. This property is located in the crmBaseAppExtModel data transform rule in the PegaCRMBase application, a built-on application shared by your Pega Customer Service for Healthcare and Pega Sales Automation for Healthcare applications. By default, this property is set to false to disable the shared features. To enable the shared features, copy the rule, and then change the property value to true.


Initiation stage

1. Log in to the application where you will create the new rule. If your applications are built on a common application that contains rules shared by both applications, create the new rule in that application. Otherwise, create the new rule in both of your applications.

2. In the Designer Studio search text field, enter crmBaseAppExtModel and then click the Search icon

.

3. In the search results, click the data transform with the Applies To class of PegaCRMBase-Data-AppExt.

4. Click Save as to save the rule to the top-level ruleset for the application, or to the ruleset identified by the project architect.

5. In the Source field, enter true.

6. Click Save.

Exposing the shared features

Although the IsCRMModeDeployment property enables the shared features, these additional rules in the PegaCRMBase built-on application expose the shared features.

l The D_crmBaseAppExtPage data page (in the PegaCRMBase-Data-AppExt class) uses the crmBaseAppExtModel data transform as a source.

l The DoesCRMExists When rule (in the @baseclass class) grants or denies access to shared features in sections, activities, and flows; this When rule refers to the D_crmBaseAppExtPage data page.

Updating an access group to allow shared accessNote: This procedure is required only if using the Pega Customer Relationship Management features.

In order for a Pega Customer Service for Healthcare operator to use Pega Sales Automation for Healthcare functionality within a Pega Customer Service for Healthcare application, you must update the access group for that operator to include the CustomerService:CSRSalesAccess access role.

This procedure is not needed for Pega Sales Automation for Healthcare operators because that application has a built-in security model.

1. Log in to your Pega Customer Service for Healthcare application.

2. In Designer Studio, click Designer Studio > Org & Security > Organization > Operators.


Initiation stage

3. In the Access group column, click the access group for an operator who requires Pega Sales Automation for Healthcare functionality.

4. In the Available roles section, click Add role.

5. Enter CustomerService:CSRSalesAccess.

6. Click Save.

7. Repeat this procedure for all Pega Customer Service for Healthcare operators who require Pega Sales Automation for Healthcare functionality.

Customer sample dataPega Customer Service for Healthcare includes sample data to support the Pega-provided demonstration application. Pega recommends that you load customer-supplied sample data so that implementation efforts are more meaningful.

Pega Marketing sample application and dataPega Customer Service for Healthcare ships with a sample Pega Marketing Healthcare application and with a set of sample offers and strategies to present context-based offers and actions in the Next Best Action widget. The sample application and data are included in the PegaCRMHCMarketingSample.zip file, located in the ResourceKit folder of the installation media.

To use the sample application and data, log in to the Pega Marketing application as an administrator, and then import the PegaCRMHCMarketingSample.zip file as described in Importing a file by using the Import Wizard.

Note: Pega Marketing is installed and licensed separately.


Initiation stage

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Prerequisites l Pega Customer Service for Healthcare and Pega Marketing must already be installed as described

in the installation guides for each product, available on the PDN.

l Before you import the sample file, run the drop script PegaCRMHCMarketingSample_Drop.sql, located on the installation media in the ResourceKit folder.

If installing the sample file as part of a Pega Customer Relationship Management for Healthcare configuration, see Optional: Configuring your applications for Pega Customer Relationship Management for Healthcare for complete configuration information.

Generating specification documents To avoid duplicating existing features, review the following documents to familiarize yourself with the default rules and rulesets of your application. During the solution assessment, a number of requirements, specifications, and other artifacts are captured to represent the scope of the work. If they are captured in the Pega Platform, these artifacts can be reused to streamline the first production release scope identification.

You can export application specification and requirements artifacts from the Pega Platform, and then import them into your new baseline application so that you can build on the content that has already been created. For more information, see Exporting specifications and requirements and Importing specifications and requirements.

Follow these procedures to generate documents that define what is contained within your application:

• Generating the Application profile

• Generating the Application document

• Generating the Specification document

Generating the Application profile This document is created during the Sales stage and includes the process stages and steps, case types, reports, requirements, specifications, participants, collaborators, and actors that are associated with the implementation of your application. It is a document that defines the scope of the application, and it also includes the results of the presale gap analysis.

When you generate this document, you can include process flow diagrams.


Initiation stage

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To generate the document, log into your application by entering your newly created credentials, and follow the procedure in Generating an application profile document.

If this is a Clinical Interaction Manager implementation, enter CimSysAdmin in the User Namefield.

Generating the Application documentThis document and its associated controls provide the ability to customize the presentation of the application information based on the document's intended audience. When you run the Application Document tool, you can include or exclude content by selecting and clearing various options.

During an implementation, this document reflects the current state of your application. The Application Document tool automatically updates the content of your document as you modify and extend your application to reflect additional requirements. If you have not yet built anything, the content of this document is the same as the application profile.

To generate the document, log into your application by entering your newly-created credentials, and follow the procedure in Generating an application document.

Generating the Specification document This document shows all of the specifications and linked requirements associated with your application at the time that you generate the document. You can generate this document at any point during the implementation life cycle to include any updates to the application's specifications and requirements.

Review this document before and after each sprint by using the available filters to tailor the content to meet the business requirements of your implementation.

To generate the document, log into your application by entering your newly-created credentials, and follow the procedure in Generating a specification document.

If this is a Clinical Interaction Manager implementation, enter CimSysAdmin in the User Name field.


Initiation stage

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Delivery stageThe Delivery stage includes the following tasks:

l Defining requirements

l Building features

l Testing a new application

l Packaging a new application

Defining requirementsTo ensure that you stay on target for a successful deployment, use a structured approach for your implementation methodology. You will need to prepare for your implementation and determine key aspects of the design that will affect the behavior of your application. Defining requirements for an implementation includes the following tasks:

l Reviewing extension requirements

l Refining customizations and determining the availability of required data and integrations

l Prioritizing, for example, revising the solution backlog, re-estimating the effort for extensions and customizations, and confirming the project scope

Defining your requirements also involves DCO sessions and incorporating those requirements into the application design. During these sessions, you review each of the case types and process flows that the application already provides.

Update the Application Specifications with planned changes as described in About Application Specifications.

The Implementation Planning Workbook helps you capture decisions as you define your requirements. You can download the Implementation Planning Workbook from the Pega Customer Service for Healthcare product page.

• Defining the case type modifications and attributes

• Defining the data model


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• Defining integration

• Defining application behavior

• Defining behavior for additional components

• Defining the user experience (UX) customization

• Defining the security model and organization structure

• Defining reporting requirements

Defining the case type modifications and attributesYour application includes a set of predefined case types. A case is defined as a service case or a service request, which is a process that your staff will execute to service your customers. Each case contains one or more processes that will be extended or created to meet your business requirements. If you do not see an existing case type, you can create one during your planning process.

Case types, in the context of a customer service application, are used to define the work your customer is asking you to perform. Examples of case types include: Review Member Benefits, Request a Prior Authorization, and Add Newborn.

The application components that you install determine which cases are available for your use.

Cases available from Pega Customer Service

The Pega Customer Service-provided cases include:

l Create a general service request

l Log a complaint or compliment

l Schedule activity

l Send correspondence

l Suggested offers

l Update contact Address

l Update contact communications options

l Update contact profile


Delivery stage

Cases available from Member Services

The cases that are provided with the Member Services component include:

l Add newborn

l Claim Inquiry

l Coordination of Benefits

l Find provider

l Medicare inquiry

l Order ID card

l Update member address

l Update PCP

l Update privacy settings

l View benefits

Cases available from Provider Services

The cases that are provided with the Provider Services component include:

l Appeal a prior authorization denial

l Dispute claim payment or denial

l Request prior authorization

l Review member benefits

l Update address

l Update credentials

l Update NPI

Cases available from Clinical Interaction Manager

The cases that are provided with the Clinical Interaction Manager component include:


Delivery stage

l Program enrollment

l Authorization request

l Visit

When you define a new case type, you provide stages for that case type. A stage is the first level of organizing work in your case type. Each stage has one or more steps.

Note: The Pega-provided application lets you select legacy case types that were created in earlier versions of the application. However, during configuration, you will notice that the legacy case types have fewer options than the newer, stage-based case types.

To define case types, complete the steps in the following topics:

• Updating case types

• Adding case types

• Work object prefixes and naming conventions

• Defining class group to database table mapping

• Confirming case type locking setting

• Pega Customer Service for Healthcare case types

• Adding important messages to case types

Updating case types

If an existing case type is close to meeting your business requirements, modify it and use it.

Note: For information on other operators and access groups when you are building on other applications, see Pega Customer Service for Healthcare operators and access groups.

1. Open Pega Express by logging in to your application with your administrator credentials.

2. To enable editing mode, click the Turn editing on link in the top-right corner.

3. In the Explorer panel, click Cases to open the Case Type Explorer.

4. Click the case type that you want to modify.


Delivery stage

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The Case Designer tool opens.

5. Use Case Designer to configure fields and data integration, stages and steps, and user views.

6. Click Done to save the changes.

Adding case types

If you require a case type that is not similar to an existing case type, create a new one that meets your business requirements.

The new case type inherits the class of the top case in the application. If a new case type requires a different class, use Designer Studio to change the top case before adding the new case type.

See Work object prefixes and naming conventions.




3. In the Explorer panel, click Cases to open the Case Type Explorer.

4. Click New at the top of the Case Type Explorer.

5. Enter the name for the new case type, and then click Next.

The Case Designer tool opens.

6. Use Case Designer to configure fields and data integration, stages and steps, and user views.

7. Click Done to save the changes.

Work object prefixes and naming conventions

Work objects (cases) capture and process information about an individual unit of work. When Pega Customer Service for Healthcare initiates a work object, a predefined model rule populates key property values that directly affect the work object. As work objects progress towards resolution, core property values, such as priority and status, are updated to reflect the current state of processing.


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Each work object has a unique property named .pyID that is computed by combining a system assigned number and a prefix, .pyWorkIDPrefix, defined by the work object model. The following lists the prefixes used by Customer Service for Healthcare.

I-

Used for interaction work objections in the PegaCPMHC-Work-Interaction work object class.

O-

Used for outbound interaction work objects in the PegaCPMHC-Work-Interaction-Outbound work object class.

Q

Used for quality review work objects in the PegaCPMHC-Work-QualityReview work object class.

QM-

Used for the quality review selection process in the PegaCPMHC-Work-QualityReview-Gen work object class.

RI-

Used for research interaction work objects in the PegaCPMHC-Work-Interaction-Research work object class.

S-

Used for all non-interaction customer service work objects in the PegaCPMHC-Work work object class.

C-

Used for non-interaction customer service work cases (cover objects) in the PegaCPMHC-Work-Cover work object class

NPS-

Used for Net Promoter surveys and follow-up cases in the PegaFW-NPS-Survey and PegaFW-NPrvey-FollowUp work object classes.

SN-

Used for social interaction work objects in the PegaCPMHC-Work-Interaction-Social work object class.

WI-

Used for web interaction work objects in the PegaCPMHC-Work-Interaction-Web work object class.


Delivery stage

Defining class group to database table mapping

To define how your cases are stored in the database, create a relationship between the class and the physical database table where the class instances will be stored. Work with the database administrator at your site on this task.

To record your decisions during this procedure, use the "Case type modifications" worksheet in the Implementation Planning Workbook. See the Classes and Properties landing page.

1. Log in to Designer Studio.

2. In the Explorer panel, click App.

3. Right-click the first class name and select Definition.

4. In the Settings section, select is a class group or belongs to a class group from the This class list.

5. If This class field belongs to a class group, then select the class from the Class group list.

6. Click Test Connection to see the name of the table currently mapped to this class.

7. Determine the name of the table that the database administrator resource at your site wants you to use for storing instances of this case type.

8. Optional: Repeat steps 2 through 6 for each class in your application.

Confirming case type locking setting

After creating and reviewing settings for each case type, determine the locking behavior of each case.

Choose any of the following locking types.

l A case is opened

Allows one user at a time to open and work on a case.

l An action taken on case

Allows multiple users to work on a case at the same time.

Note: If you have already considered and set the locking behavior for each case type, you can skip this step.


Delivery stage

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Identifying the most appropriate lock setting for your application is important because it can affect the throughput of work in your application. For example, if user1 locks a case to work on it, then other users cannot work on the locked case until user1 unlocks the case or the lock expires according to the timeout period.

Contrary to this, if multiple users are allowed to work on a case simultaneously, the case content could be modified for one or more users while they work on the case. For example, assume that user1 is working on a case then user2 opens the same case a few minutes later. When user1 saves changes to the case, user2 is notified of the changes and is enforced to accommodate changes done by user1 in the case.

To record your decisions during this procedure, use the "Case type modifications" worksheet in the Implementation Planning Workbook.


2. In the Explorer panel, click Cases.

3. Click the first case type.

4. Click Locking in the case-wide settings.

5. Determine if the case should be locked when the case is opened or when an action is taken on the case.

6. Determine the lock timeout period for this case.

7. If you are certain at this point how locking should be handled for this case type, you can update this setting now.

8. Repeat these steps for each case type.

Pega Customer Service for Healthcare case types

The application components that you install determine which cases are available for your use.

Cases available from Pega Customer Service

The following cases are provided by Pega Customer Service:

l Complaint or compliment

l General service request

l Schedule activity


Delivery stage

l Send correspondence

l Update contact profile

Cases available from Member Services

The following cases are provided with the Member Services component:

l Coordination of benefits

l Claims inquiry

l Update member profile

l Update PCP

l Update privacy settings

l Add newborn

l Find provider

l Order ID card

l View benefits

l Create business lead

l Create individual lead

l Create individual opportunity

l Schedule appointment

Cases available from Provider Services

The following cases are provided with the Provider Services component:

l Appeal a prior authorization denial


l Coordination of benefits

l Claims inquiry


Delivery stage

l Review member benefits

l Update practitioner address

l Update hospital admitting privileges

l Update practitioner business affiliations

l Update practitioner languages

l Update practitioner license

l Update practitioner NPI

l Update specialties

Cases available from Clinical Interaction Manager

The following list includes the cases that are provided with the Clinical Interaction Manager component:

l Program enrollment


l Visit

Adding important messages to case types

Pega Customer Service for Healthcare now includes a re-usable process, named Important Messages. With this feature, you can create mobile push notifications, proactive emails, and self-service messages from within a case. You can add this process to any case in your application. For example, when an appeal decision has been reached, Pega Customer Service for Healthcare can send a mobile push notification to the customer.

1. Using the case types listed in Defining the case type modifications and attributes, determine the case types for which important messages are needed.

2. For each case type, follow the steps in Configuring important messages.

Defining the data modelThe application provides a set of data types, data pages, and sample data to begin implementing your application. You will need to use the data from your site's system of record instead of using the


Delivery stage

sample data provided by the application.

To view the application data types and the currently configured sources for each data type, open the External Data Entities landing page.

Application data model

The application provides a set of data types, data pages, and sample data, which you can use to begin implementing your application.

Data modeling involves creating a conceptual model of how data items relate to each other in an application. In the Pega Platform, the data model refers to a set of rules that work together to populate the data in your application. The system displays this data to help you process the information and can help you make decisions in your sales processes. The following rule types constitute your data model:

Data types

Data type is another name for a class in your application. It holds data that the application uses. A data type has one or more data pages and several property definitions associated with it.

Properties

Properties define the format and visual presentation of data in your application.

Data pages

Data pages define the content of a clipboard page. Data pages also control the loading of that data from a source system, as shown here.


Delivery stage

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When planning your data model, work with the data modeling resource at your site to understand the attributes of the data types that need to be supported by your application.

Note: Pega Customer Service for Healthcare uses Pega's system of record for application data. Optional: You can integrate your application data with your Pega's system of record.

Defining integrationInventory which external applications exist at your site and plan how to connect to them.

Some common integration points for the Pega Customer Service for Healthcare application include interfaces to the following systems:

l Customer system of record

l Agent and agency system of record

l Policy administration system

l Rating system

l Billing system

l Form generation system

l External reference systems (for example MVR and MIB, or Rx systems for <app name>)

Some common integration points include interfaces to information on the following:

l Members

l Providers

l Claims

l Authorizations

l Policies

l Business entities

l Benefits


Delivery stage

Tip: Identify integration points as early in your planning as possible. If a connection to an external data source is required and either the data does not exist or the interface to that data does not exist, you must account for the time to publish these data sources and the time to configure the interface for this application.

The External Data Entities landing page lists the application data types and shows the source for that data.

To record your decisions during this procedure, use the "Integration" worksheet in the Implementation Planning Workbook.

1. Identify all integration points for your application.

2. Identify which data is needed from each system of record, if you have not already done so during the defining the data model step.

3. Determine whether an interface to that system of record already exists and how to connect to it.

Mapping application data

The application data types provide a default set of properties for your use. You can add or remove properties from these data types depending on your requirements. You can also add new data types.

To record your decisions during this procedure, use the "Data planning" worksheet in the Implementation Planning Workbook.



2. In the Explorer panel, click Data. The list of all available data types is displayed. By default, Pega Customer Service includes , Contact, Organization, and Address and their relationship data types.

3. Click the first data type.

4. On the Data model tab, determine the properties to add, remove, or leave unchanged. For more information about data types, see Viewing data type details.

5. Repeat steps 3 and 4 for all existing data types.

You can also use the "Data planning" worksheet to record any new data types that are needed by the application.


Delivery stage



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Defining application behaviorTo configure the functionality provided in Pega Customer Service for Healthcare, complete the following procedures.

• Defining interaction types, driver categories, and tasks

• Defining dialogs and coaching tips

• Defining the search behavior

• Defining the interaction goals

• Defining the call duration goal

• Defining the call verification method

• Defining application settings

• Defining customer events to track

Defining interaction types, driver categories, and tasks

Interaction types (known as Channels in the Interaction Portal during Pega Express configuration) and driver categories (known as Add Task menu categories in the Interaction Portal during Pega Express configuration) determine the tasks to which a user has access to during an interaction with a customer. The interaction type appears in the menu when you click the +New menu in the header of the Interaction Portal. The +New menu enables you to start a new Interaction.

When you finish running the New Application wizard in the Designer Studio, the interaction types are created for you. You can determine which tasks are associated with those interaction types or channels. The defined tasks appear in the Add Task menu of the Interaction Portal during a customer interaction.

• Defining interaction types

• Defining Interaction Driver categories

• Defining intent tasks


Delivery stage

Defining interaction types

Use the "Interaction types" (known as Channels in the Interaction Portal during Pega Express configuration) worksheet in the Implementation Planning Workbook to record your decisions during this procedure.


2. Click Designer Studio > Customer Service > Interactions > Interaction Types.

3. In the Show interaction types in list, select All Inherited.

4. Click Run.

5. Determine the interaction types that your application is going to use.

6. For each interaction type, determine if it should be present in the +New menu of the Interaction Portal.

Defining Interaction Driver categories

Use the "Interaction driver categories" (known as Add Task Menu Category in the Interaction Portal during Pega Express configuration) worksheet in the Implementation Planning Workbook to record your decisions during this procedure.


2. Click Designer Studio > Customer Service > Interactions > Interaction Driver.

3. In the Show Drivers in list, select All Inherited.

4. In the Show categories for this interaction type list, select the first interaction type for your application.

5. Click Run.

6. Determine the category name, data source, and behaviors for this interaction type.

7. Repeat for each interaction type for your application.

Defining intent tasks

Using the Intent Tasks tab, you can link a case type to an interaction type and driver category. If you added new case types to your application, you can define a corresponding new interaction task


Delivery stage

in Designer Studio to set up the intent task (known as Service request options during Pega Express configuration).

To record your decisions during this procedure, use the "Interaction to task mapping" worksheet in the Implementation Planning Workbook.


2. Click Designer Studio > Customer Service > Interactions > Intent Tasks.

3. In the Show Interaction Driver Tasks in list, select All Inherited.

4. Select the first task in the Show Tasks for Interaction Type field for your application.

5. Click Run.

6. Determine the Intent Tasks that should be available for this interaction type.

Tip: Click Export to Excel to make reviewing easier.

7. Repeat for each interaction type for your application.

8. In the Explorer panel, click Records > Process > Intent Task.

9. From the list of intent tasks displayed, identify the task that should be available for your implementation application.

Defining dialogs and coaching tips

Dialogs and coaching tips help the support representative provide the best possible experience for the customer. Dialog and coaching tips are not enabled for mobile interactions.

Note: Integration with the optional Pega Knowledge application enables Pega Customer Service for Healthcare to suggest contextual content to representatives in the context of the service processes that they are working on. For information about how to plan for Pega Knowledge integration, see Defining the Pega Knowledge configuration.

Mapping the dialogs to the flows

Dialogs prompt the representative to ask the customer for the right information needed to resolve the request. Using the Configuration Tools option, users with the Manager role can update the dialogs directly in the flow action that requires it.


Delivery stage

To record your decisions during this procedure, use the "Dialog" worksheet in the Implementation Planning Workbook.


2. Click Designer Studio > Customer Service > Dialog Management > Dialog Cross Reference.

3. In the Show references in field, select All Inherited.

4. Click Run.

5. Select the first Work Type (case type).

Tip: You can click Export to Excel for easier viewing of these records.

6. Determine the dialog that should be associated with each flow action.

7. Repeat these steps for all application work types.

For more information on how to configure and edit dialog or coaching tips, see Configuring dialogs and coaching tips.

Defining coaching tips

Authorized supervisors or managers create coaching tips for their employees that remind them of best practices or areas to improve. Coaching tips are assigned to individual customer service representatives or to entire work groups.

To record your decisions during this procedure, use the "Coaching tip" worksheet in the Implementation Planning Workbook.


2. Click Designer Studio > Customer Service > Quality management and coaching > Coaching Tip Inventory.

3. In the Show coaching tips in field, select All Inherited.

4. Click Run.

5. For each work type, click the corresponding Action column to see the existing coaching tip.

6. Determine the coaching tip for the work type, process action, user, and workgroup.


Delivery stage

Defining knowledge content integration

The Pega Knowledge application supports the creation of contextual, multi-media content. Knowledge articles can be linked directly to service cases so that they are suggested to the customer service representatives, providing quick, contextual answers to expedite resolution to customer issues. This application is licensed separately from Pega Customer Service for Healthcare.

If you plan on using this feature, complete the following steps. To record your decisions during this procedure, use the "Pega Knowledge" worksheet in the Implementation Planning Workbook.



3. Click the first case type in your application.

4. Click Run to run the processes for that case type.

5. Determine the knowledge content needed for each stage and step in your process.

6. Repeat steps 1 through 4 for all case types.

For more information on configuring a Pega Knowledge content, see Configuring Pega Knowledge content.

Defining the search behavior

Users can search for cases, knowledge content, and data such as accounts, contacts, and business units in the application portals. To search for instances related to Customer Service data source instances, you can configure the portal search option on the data source form as described below. For all other instances, you can use the Full-text search.

To record your decisions during this procedure, use the "Portal search" worksheet in the Implementation Planning Workbook.


2. Click Designer Studio > Customer Service > Customer Data Management > Customer Service Data Sources.

3. In the Show data sources in field, select All inherited.


Delivery stage

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4. Click Run.

5. Determine which data sources should be searchable.

Defining the interaction goals

The application displays an interaction goal to the user to guide the conversation with the customer. For example, values for customer value and net promoter category can affect how the representative interacts with the customer.

To record your decisions during this procedure, use the "Interaction goal" worksheet in the Implementation Planning Workbook.


2. In the Explorer panel, click Records.

3. In the Records pane, expand Decision, and then click Decision Table.

4. In the Purpose field, click the filter icon and enter DetermineInteractionGoal in the Search Text box.

5. Click Apply.

6. In the results list, click each instance of DetermineInteractionGoal in the latest ruleset.

7. In the decision table, review the value in the Conditions column to determine which properties drive the value of the interaction goal property.

Tip: For example, see the DetermineInteractionGoal decision table in the sample ruleset.

8. Click the Results tab.

9. In the Results section, expand Additional Allowed Results to determine if any new return values need to be added.

Defining the call duration goal

The call duration goal provides a call guidance message to the representative during a phone interaction. The DetermineCallDurationGoal decision table can include information such as contact center volume indicator, customer lifetime value, and last NPS score to set the value of the call duration goal.


Delivery stage

To record your decisions during this procedure, use the "Call duration" worksheet in the Implementation Planning Workbook.



3. In the Records pane, expand Decision, and then click Decision Table.

4. In the Purpose field, click the filter icon and enter DetermineCallDurationGoal.

5. Click Apply.

6. In the results list, click the instance of DetermineCallDurationGoal in the latest ruleset.

7. In the decision table, review the value in the Conditions column to determine which properties will be used to set the call duration value.

8. Click the Results tab.

9. In the Results section, expand Additional Allowed Results to determine if you need to add any entries need to the allowed results.

Defining the call verification method

When customers contact a customer support center, their authenticity is verified through account or contact information. In addition to existing verification methods, a new verification method can also be added by appending a new method to the AppVerificationParam map value.

To record your decisions during this procedure, use the "Call verification" worksheet in the Implementation Planning Workbook.

Follow these steps to determine the value for this setting.



3. In the Records pane, expand Decision, and then click Map Value.

4. In the Map Name field, click the filter icon and enter AppVerificationParam.

5. Click Apply.


Delivery stage

6. In the results list, click the PegaCA-Work version of AppVerificationParam in the latest ruleset.

7. Click the Configuration tab.

8. In the Results section, review the Additional Allowed Results for the map value.

9. Determine which method you will use to verify your customer.

Defining application settings

In Pega Customer Service for Healthcare, you can configure your application settings based on how you want your application to behave.

To record your decisions during this procedure, use the "Application settings" worksheet in the Implementation Planning Workbook.

1. Determine whether to enable an automatic refresh for the My Work tab.

2. Determine whether to display the call volume indicator and then determine the refresh rate.

3. Determine how to set refresh rates for the following items.

l Messages and alerts

l Call timer

4. Determine whether to enable Pega Knowledge for the display of applicable articles to the Customer Service Representative (CSR) during a call.

5. Determine whether to enable Co-Browse so that you can share a browser session with a customer.

6. Determine whether to enable Pega Customer Decision Hub for the display of suggestions for the next best action based on the current context.

To configure these settings in the software, see Configuring application settings.

Defining customer events to track

Pega applications automatically track the most common customer activities and display the activities chronologically in a Customer journey widget on the customer composite. To track an additional activity, create an event for the activity.


Delivery stage

For more information about tracking customer events, see Timeline view of customer events on the PDN.

To record your decisions during this procedure, use the "Customer events" worksheet in the Implementation Planning Workbook.

1. Determine whether there are customer events that you want to track that are not tracked by default. To view a list of event types that are always tracked, see Timeline view of customer events on the PDN.

2. For each new event that you want to track, determine the source of the event, the source of the customer ID, and the storage and retrieval options.

For information about how to configure a new event type, see Creating an event type in the Event Catalog.

Defining behavior for additional componentsYour implementation can have multiple components associated with it. Each of these components requires planning for a successful implementation.

• Defining Pega Intelligent virtual assistant for the Facebook Messenger configuration

• Defining Pega Co-Browse configuration

• Defining the Pega Knowledge configuration

• Defining Pega Customer Decision Hub and Customer Decision Hub behavior

• Defining Pega Social

• Defining Pega Call configuration (telephony integration)

• Defining Pega Chat requirements

• Defining Net Promoter Score settings

Net Promoter™ capability is part of the Pega Customer Service for Healthcare application, but its use is optional. Pega Co-Browse, Pega Knowledge, Pega Marketing, Pega Social, Pega Call, and Pega Chat are optional components that can be implemented at the same time as Pega Customer Service for Healthcare, or added to the application afterwards.


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Defining Pega Intelligent virtual assistant for the Facebook Messenger configuration

Customers can use Pega Intelligent virtual assistant to interact with Pega Customer Service for Healthcare using the Facebook Messenger. The Pega Intelligent virtual assistant for the Facebook Messenger provides automated answers to customer questions. When a customer wants to chat with a customer service representative, the Intelligent virtual assistant escalates the current chat session to a customer service representative. Escalation requires the Pega Chat application.

The customer service representative can review the current interaction transcripts before responding to the chat request. Also, the customer service representative can select any in-progress service case listed under Next Best Action and continue processing the case from the point where it was transferred by the Intelligent virtual assistant.

Pega Customer Service for Healthcare includes the Pega Intelligent virtual assistant for the Facebook Messenger feature in several service case types.

For information about how to add this feature to a service case type, see Configuring the Facebook channel on the PDN.

To record your decisions during this procedure, use the "Pega Intelligent virtual assistant for the Facebook Messenger" worksheet in the Implementation Planning Workbook.

1. Decide whether you want to use an Intelligent virtual assistant for any of your service case types.

2. Decide which Facebook page you will use to configure the Intelligent virtual assistant. For more information, see Configuring the Facebook channel on the PDN.

3. Identify the Facebook channel you will use to configure the Intelligent virtual assistant. For more information, see Configuring the Facebook channel on the PDN.

4. Identify case types that will support Intelligent virtual assistant interactions with customers. For more information, see Configuring a case for an Intelligent Virtual Assistant for Facebook Messenger on the PDN.

5. Decide whether your application requires customized responses, in addition to the application-provided responses. For example, configure the Pega Intelligent virtual assistant to provide a business-specific error message instead of the generic error message. For more information, see Configuring Facebook chatbot system responses on the PDN.


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6. Decide whether you need to modify the text analyzers. For more information, see Natural language processing text analyzers on the PDN. Also, decide whether to support a custom taxonomy, and, if yes, which custom categories to add to the text analyzers.

7. Determine which Pega operator ID you will use as a template for the Pega operator ID that gets created when a new user interacts with the Intelligent virtual assistant. Select a template with the appropriate access group and roles for the most likely interaction types.

Defining Pega Co-Browse configuration

With Pega Co-Browse, your customers and agents can collaborate by sharing a web browser session on the customer's PC, tablet, or mobile phone.

To record your decisions during this procedure, use the "Co-Browse" worksheet in the Implementation Planning Workbook.

1. Determine which activation mode presenters will use to invoke the Co-Browse session.

l Stealth - Enables the presenter to use the Ctrl+Enter key combination to start the session. To use Pega Co-Browse with Pega Chat, always select this mode.

l API - Enables the presenter to start a Co-Browse session using a custom method that they have defined using JavaScript and the Co-Browse API. For example, they could start a session from a custom button.

l Button - Enables the presenter to start a Co-Browse session by clicking a Support button on the left side of the web page. This is the default mode.

For more information about how to configure each mode, see the Pega Co-Browse Implementation Guide on the Pega Customer Service product page.

2. Determine which web pages that you would like Co-Browse to work on.

3. Determine which website fields require masking.

4. Determine whether the Pega Co-Browse window must be customized to match branding standards at your site.

5. Define a message that you want to appear before the viewer connects with the presenter.

6. Determine whether to enable remote control. Remote control allows the viewer to take control of the presenter's screen.


Delivery stage

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Defining the Pega Knowledge configuration

Pega Knowledge is a standalone application that is integrated with Pega Customer Service for Healthcare. Pega Knowledge supports the creation and organization of rich content that can be suggested to representatives in the context of the service processes that they are working on.

Planning your application to support Pega Knowledge involves three major tasks.

l Identifying service cases that need content.

l Developing relevant content needed to support specific service cases.

l Identifying the product lines that need Pega Knowledge articles.

When planning, focus on which content is necessary for complex service cases. Write the content concisely and limit the number of Pega Knowledge articles so that the agent does not have a large number of search results.

To record your decisions during this procedure, use the "Pega Knowledge" worksheet in the Implementation Planning Workbook.


2. Click the first case type in your application.

3. Click Run to run the processes for that case type.

4. Determine the knowledge content that is needed for each stage and step in your process.

5. Repeat these steps for all case types.

To configure Pega Knowledge content in Pega Customer Service for Healthcare application, see Linking Pega Knowledge content.

Defining Pega Customer Decision Hub and Customer Decision Hub behavior

With Customer Decision Hub, you can configure communication with the Pega Customer Decision Hub application. Pega Customer Decision Hub can be used with Pega Customer Service for Healthcare to drive up-sell, cross-sell, and retention offers, and provide additional guidance to representatives on the next best action for the current customer and context. These suggestions appear as Suggested Tasks during the interaction. Customer Decision Hub also helps the wizard to create the marketing-related rules in the new application layer interaction.


Delivery stage

Note: To use this feature, ensure that Pega Customer Decision Hub is installed and licensed. If using local campaigns with a Pega Sales Automation application, Pega Web Mashup must also be installed on the Pega Customer Service for Healthcare application server. For more information about Pega Marketing, see the Pega Marketing page. For information about how to install Pega Customer Decision Hub, contact your Pega support representative.

For more information on configuring Customer Decision Hub, see Configuring Customer Decision Hub.

Defining Pega SocialCustomers can implement Pega Social at the same time as Pega Customer Service for Healthcare, or they can add this component later.

For information about the planning considerations for a Pega Social implementation, see Pega Social configuration .

Defining Pega Call configuration (telephony integration)

Planning for telephony integration involves two major tasks.

l Planning the infrastructure

l Planning the Customer Service Representative (CSR) experience once the call is received

Planning the connectivity to your telephony infrastructure 1. Understand which telephony vendor that your site uses.

2. Review the Pega Call CTI Implementation materials to understand the configuration for your vendor.

3. Meet with the technical resources responsible for configuration and maintenance of the Contact Center Telephony and CTI infrastructure at your site to get an understanding of the current configuration and desired call flows and customer experience.

Ensure that a resource from the telephony team is available to work with the Pega Call implementation team.

4. Share the information related to the way Pega Call gets connected to the CTI environment with the telephony expert. The telephony expert is required to configure the CTI environment to allow Pega Call to connect and share the configuration details with the Pega Call implementation team.


Delivery stage

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To record your decisions during this procedure, use the "Pega Call telephony setting" worksheet in the Implementation Planning Workbook.

For more information on CTI-specific configuration details, see the individual configuration guides available on the Pega Call product page.

Planning the CSR experience

To record your decisions during this procedure, use the "Pega Call telephony setting" worksheet in the Implementation Planning Workbook.

1. Determine how customer service representatives control their phone calls (hold, retrieve, and transfer) and manage their agent state (make themselves available or unavailable to receive customer calls). A CSR can choose to take calls by using Pega desktop application (full telephony mode) or another tool. For more information, see the individual configuration guides available on the Pega Call product page.

2. Determine which data will be sent from the telephony environment to the Pega Platform. Understand which variables and formats will be used for the data and determine how to map these to Pega Platform properties.

3. Determine how the call will be handled when it arrives at the user's desktop.

l Screen Pop – A popup notification displays information about the incoming call. Determine which telephony elements will be displayed on the screen pop window.

l Start Interaction (also known as Auto-Accept) – A call interaction is started automatically. No screen pop window is displayed.

l No Action – No interaction or screen pop window is triggered. For example, use this setting for internal calls that are not related to the customer interactions.

4. If the call is handled by a screen pop or start interaction, determine the timeout. For more information, see Configuring screen pops section in the configuration guide found on the Pega Call product page.

5. Determine which type of call transfers will be supported.

l Warm transfer – The customer service representative receiving the transfer has the opportunity to consult with the person transferring the call and has the option to accept the call.

l Blind transfer – The call is transferred without the CSR first talking with the transferee. The call is transferred without a consultation call.


Delivery stage





6. Define transfer reasons. Default reasons include Call in Wrong Queue, Caller Needs Additional Services, Escalated to Supervisor, and Other.

Note: Use this option only if you want to transfer the interaction and cases with the call.

Defining Pega Chat requirements

Customers can implement Pega Chat at the same time as Pega Customer Service for Healthcare, or they can add this component later.

For information about the planning considerations for a Pega Chat implementation, see Pega Chat implementation.

Defining the chat queues and operator skills

A chat queue is the work queue for chat requests that are received from one or more chat-enabled web pages. The chat server routes a chat request to a CSR based on whether the CSR has the required skills for that queue, and whether the request is received during working hours for that queue.

For a chat window, you can configure a chat queue to send pre-chat questions to a customer in order to gather information before the chat request is routed to a CSR. For example, the chat server can request a customer’s name, account number, and the question that they have.

The answer can be used for subsequent interaction processing.

Note: If the answer to a pre-chat question is known before the chat session starts, you can pre-populate the answer when you enable chat for a web page. In that case, the chat server will not ask the pre-chat question. An answer can also be pre-populated automatically by your website based on user login credentials or other information. For information about how to pre-populate an answer, see Enabling chat on your website.

To record your decisions during this procedure, use the “Chat queues” worksheet in the Implementation Planning Workbook.

1. Identify the different types of chat requests that you expect to receive and the skills required to service each request.

2. Determine how many different chat queues you need to route chat requests to operators with the required skills.

3. Determine a name for each chat queue.

4. Identify the hours of operation for each chat queue.


Delivery stage

5. Determine what message to display when a customer requests a chat session outside of business hours for the chat queue.

6. Determine what message to display when a customer requests chat when there are no agents available or no agents available with the required skills.

7. Determine the service level goals for each chat queue. Identify the percentage of chat customers that your CSRs should be able to respond to, and the number of seconds within which they should respond.

8. Determine which pre-chat questions you want to ask for each chat queue.

9. Define a property name (also known as a key) for each pre-chat answer. During a chat interaction, a CSR can access the property and other metadata related to this chat request from their Pega clipboard.

The metadata are available in the form of key-value pairs in a value group ChannelServicesInteraction.pyUserData on the interaction page. Answers to pre-chat questions are accessed from pyUserData using the key specified. The answers can be displayed on the CSR desktop, and they can be used to trigger, modify, or suggest service processes.

The Configuring channels topic describes tasks that can include Pega Chat metadata.

10. Determine whether and when to pre-populate pre-chat answers. For example, certain values might be pre-populated based on the user's profile on your website.

11. Identify which CSR operators have the required Pega Chat skills to respond to the chat queue. For information about defining operator skills, see Defining the operator attributes.

Note: Only the following characters are allowed in the operator ID of a Pega Chat CSR: alphanumeric characters, @, &, ', and <space>. The operator ID cannot contain any other special characters, nor can it contain more than one @ symbol.

For more information on how to configure, see Configuring chat queues for Pega Chat.

Defining common phrases

Pega Chat lets CSRs insert frequently used phrases in the chat window by selecting them from the Phrases menu during a chat session.

To record your decisions during this procedure, use the “Common phrases” worksheet in the Implementation Planning Workbook.


Delivery stage

1. Define the categories of common phrases that will be seen by the CSR. During a chat session, each category is presented to the CSR as a separate submenu from which they can select a phrase.

2. Define a short name for each phrase that will clearly identify the phrase to the CSR.

3. Define the complete text that a customer sees in the chat window when a CSR selects the phrase. If the phrase includes text that is formatted as a link (for example, the text starts with "http://"), then the chat window converts the text to a link when a CSR sends the phrase.

4. To restrict selection of this phrase to customers with specific browser locales, identify the language of the phrase. By default, a phrase applies to all languages and locales.

For more information of configuring common phrases, see Configuring common phrases.

Defining web pages to push for chat

During a chat session, a CSR can select a chat-enabled web page to share with a customer in order to guide them or point them to the information that they need. The customer receives a message asking for permission to redirect their web browser to the pushed page.

To record your decisions during this procedure, use the “Page push for chat” worksheet in the Implementation Planning Workbook.

1. Define categories of pages to push as will be seen by the CSR. During a chat session, each category is presented to the CSR as a submenu from which they can select a web page.

2. Define a name that identifies each chat-enabled web page that a CSR can push during a chat session.

3. Define the URL of each chat-enabled web page that a CSR can push during a chat session.

4. To restrict selection of this web page to customers with specific browser locales, identify the language of the web page. By default, a shared web page applies to all languages and locales.

For more information on configuring page push, see Configuring Page push.

Defining Net Promoter Score settings

During interaction wrap-up, the application calculates a Net Promoter Score™ based on the response to this question: On a scale of 0-10, how likely are you to recommend us to a friend? This response can be used to drive future interactions with the customer.


Delivery stage

The Net Promoter application, bundled with core Pega product, is an optional component of Pega Customer Service for Healthcare. When installed, the application generates follow-up cases for managers and supervisors to investigate.

Note: Pega Customer Service for Healthcare includes customer satisfaction survey capabilities that you can leverage if you do not have the Net Promoter application installed. For more information about customer satisfaction survey configuration, search for the related topics on the PDN.

If you are using the Net Promoter application, follow these steps.

1. Determine how the follow-up cases from Detractor or Passive scores will be handled.

2. Record your decisions in the "Net Promoter Score worksheet" in the Implementation Planning Workbook.

For more information, see the Net Promoter Tech Note on the Pega Customer Service product page.

Defining the user experience (UX) customizationCustomizing the Pega Customer Service for Healthcare user experience to meet the UX standards at your site includes the following procedures.

• Designing the customer composite

• Designing the portals

• Determining the application skin and styles to modify

• Designing for screen performance

• Designing web self-service

• Determining which part of the user interface to modify

Localization and accessibility are also common user experience requirements. For more information, see the Pega Platform help.

Designing the customer composite

For better application performance and usability, you should show data on the customer composite only when that data is needed. By using consistent criteria, you can determine the relative importance of each field and make the best decision on where to place each field on the display.


Delivery stage



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To record your decisions during this procedure, use the "Customer composite" worksheet in the Implementation Planning Workbook.


2. Click Launch > Interaction Portal.

3. Click +New > Demo Screen Pops > Demo Pop - JOHN BROWN.

4. Click Accept.

5. For each field on the customer composite, determine the following information.

l If this information is needed more than once during the call.

l The probability of the information to be referenced during the call.

l The probability of the information to change the customer's behavior, questions, or perception.

l The probability of the information to change the representative's behavior.

l The time frame when this information is needed.

6. Based on these responses, determine the following information.

l If the information should be visible, available, or accessible.

Visible: Always present on the screen.

Available: Ability to quickly view and make permanently visible.

Accessible: Data is reachable within 2 clicks.

l Which screen quadrant should show the information.

Designing the portals

To ensure a more effective user experience, determine the contents of the Interaction portal to ensure that only relevant data is presented. In addition, determining how users enter the application, including customers, helps you plan for a better overall experience.

Defining the dashboard personalization

To record your decisions during this procedure, use the "Portals" worksheet in the Implementation Planning Workbook.


Delivery stage



3. Open the Dashboard section.

4. To edit and personalize the dashboard, click the Personalize dashboard icon .

5. In the Edit dashboard section, choose your layout template and add your own widgets or select from the set of available widget options.

6. Click Publish to publish your settings. You can choose to publish the settings to the default dashboard or to the access group.

7. Review the My Reports, Manager Tools, and Pulse and determine if any modifications are required based on your business needs.

8. Repeat these steps for the Account Manager portal.

For more information, see Configuring your dashboard.

Defining application entry point

The Pega Customer Service for Healthcare portal can be accessed as is, or individual processes can be embedded as a mashup in an existing portal or application.

1. Review features provided by Pega Web Mashup.

2. Discuss these options with the resource currently managing the application in which you want to embed your process.

3. Decide on the most appropriate entry point for your site.

These processes can also be made available to your customers directly. See Designing web self-service.

Determining the application skin and styles to modify

You can customize the skinning of the application so that it complies with the branding and styling standards at your site.

To record your decisions during this procedure, use the "Skinning" worksheet in the Implementation Planning Workbook.


Delivery stage

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2. Click Designer Studio > User Interface > Skins, interfaces, & templates.

3. On the Skins tab, double-click the CSEndUser skin in the PegaAppCA ruleset.

The Component styles tab opens.

4. Determine which components require customization and update.

For more information on customizing the application skin and styles, see Component styles tab of the Skin rule form.

Designing for screen performance

Determine screen performance requirements for your applications. The following list describes examples of performance requirements.

l The round-trip time from the server to client must be 1 second or less.

l The screen-to-screen time must be less than .5/second.

To design for these types of requirements, consider the following items.

1. Which business service level agreements exist. For example, the customer details must be available in one second or less while a representative is on the phone with the customer.

2. How long it takes backend systems to gather the data it needs to display customer details.

3. Which fields does the representative absolutely need for the task that they need to perform.

4. Whether any network configuration could cause latency, for example, representatives logged in through the corporate VPN or in a remote location.

Designing web self-service

You can allow your customers to directly perform tasks themselves in the Pega Customer Service for Healthcare application using web self-service. Web self-service capabilities can be implemented by performing the following tasks.

l Embedding a portion of the application directly into an existing portal. This is done through Pega Web Mashup.


Delivery stage

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l Providing the Pega application itself as the user experience. This approach can take the form of a desktop application, a mobile application, or both.

1. Review features offered by Pega Web Mashup.

2. Review features offered by Pega Mobility.

3. Discuss these options with the resource currently managing the customer-facing user experience.

4. Determine the approach most appropriate for your site.

Determining which part of the user interface to modify

When users first access the Interaction Portal, they see the Home page, which typically contains information about the user, a menu along the left side, and various sections such as My cases and My workbaskets that display information to a customer service representative (CSR). You can customize the user interface and display any data that you have integrated into your application.

For more information to modify user interface, see Modifying the user experience.

Defining the security model and organization structureSecurity planning involves defining authorization and authentication strategies for your application.

l Authentication

Proves to the application that you are who you say you are.

l Authorization

Determines the functions that you can perform in the application. This corresponds to access group and role configuration.

Security planning also involves setting up the organization structure and operator attributes.

The application provides security in the form of access settings and denial rules. Many integration rules also incorporate authentication.

For more information about the additional aspects of security, enroll in the Lead System Architect course on Pega Academy and cover the Security lessons that correspond to the following topics:

• Authentication schemes

• Defining your authentication scheme


Delivery stage


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• Defining your authorization scheme

• Defining the organization

• Defining the operator attributes

Authentication schemes

The Pega Platform offers the following authentication types:

PRBasic

Based on passwords in the Operator ID data instances and the login form. This is defined by the HTML @baseclass.Web-Login rule, which your application can override.

PRSecuredBasic

Similar to PRBasic, but passes credentials using Secure Sockets Layer (SSL) using Basic HTTP authentication. The login form is defined by the HTML @baseclass.Web-Login-SecuredBasic rule, which your application can override.

PRCustom

Supports access to an external LDAP directory or a custom authentication scheme.

PRExtAssign

Supports external assignments (Directed Web Access).

J2EEContext

Specifies that the application server in which the Pega Platform is deployed uses JAAS to authenticate users.

Defining your authentication scheme

Your site can use a centralized, automated means of maintaining operator data instead of maintaining it manually in your application.

To record your decisions during this procedure, use the "Security Model" worksheet in the Implementation Planning Workbook.

1. Discuss Authentication schemes with your site's security and application server teams.

2. Determine the appropriate authentication type.


Delivery stage

For more information on authentication scheme planning, see Authentication in the Pega Platform.

Defining your authorization scheme

Pega Customer Service for Healthcare comes with a predefined set of access groups, roles, and privileges. You can use the application roles as a starting point, but you should create your own application-specific access groups and roles to avoid any future problems when upgrading.

Other rule types such as sections, flow actions, and activities use roles and privileges to allow access to these rules at run time.

Tip: You can review the Pega Customer Service for Healthcare access groups and roles in Pega Express. Log in to Pega Express, Click Users panel > Roles.

Defining access roles and privileges

You can associate one or more roles to an access group. Roles are additive. The more roles that you add to an access group, the more authorization there is. Privileges can be associated with one or more roles.

To record your decisions during this procedure, use the "Security model" worksheet in the Implementation Planning Workbook.

1. Determine which roles are needed for your application. You can use the Pega Customer Service for Healthcare roles as a starting point.

2. Determine which privileges to associate with each role.

3. Associate each role with an access group.

For more configuration information, see Groups and roles.

Defining your access groups

To record your decisions during this procedure, use the "Security model" worksheet in the Implementation Planning Workbook.

1. Identify additional access groups that are needed for your application.

2. Identify portals associated with these access groups.


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Defining the organization

Use the organization structure for routing and reporting within the application. Typically, the application organization structure does not map operators exactly to the site's organization chart but instead, it maps the work that those operators do.

1. For additional guidance, see Organization landing page.

2. To record your decisions during this procedure, use the "Organization structure" worksheet in the Implementation Planning Workbook.

To configure your organization, see Updating business organizations.

Defining the operator attributes

An operator's access group affects what the operator can do in the application. In addition to the access group, three fields in the operator record influence how the application handles assignment of work to the user.

l Work group

l Skills

l Calendar

Tip: In many implementations, it is more efficient for the application to set values in the operator record during the authentication process than it is to have an administrator manually maintain these records. These rules must be configured as part of the authentication mechanism for your site. For more information, see More about Authentication Services.

Defining the operator work group

The work group setting in the operator record affects how the application delivers work to the operator.

1. Review the Operator record.

2. Determine the rules for assigning a work group to an operator or the role that multiple operators hold.

To record your decisions during this procedure, use the "Organization structure" worksheet in the Implementation Planning Workbook.


Delivery stage

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2. Click Designer Studio> Org & Security > Organization > Operators.

3. Select an operator ID.

4. On the Work tab, review the work group information for the operator record.

5. Determine your policy for assigning a work group to an operator or the role that multiple operators hold.

Defining the operator skills

Skill settings in the operator record affect how the application routes work to the operator. Skill settings also affect how the application gets the most appropriate work when using the Get Next Work feature. You must determine the skills that are appropriate for your application and operators.


1. Define the skills that are needed for the application.

2. Determine which operator records or roles should be associated with those skills.

Defining the operator calendar

The application calendar affects date calculations within the application, such as the date between business days calculation, and the SLA goal and deadline date calculation. The calendar on the operator record is relevant only if you have users who are not working in the same time zone as the rest of the organization. Otherwise, the application uses the calendar on the organization record and you can skip this step.

Operator calendars will have an impact on chat availability. If a chat request comes in after or before the business hours defined in the specified calendar, then the requestor receives "Off-hours behavior message".


1. Determine the calendar instances that are needed for your application.

2. Determine which operator roles need a distinct calendar.

3. Determine the operator location.


Delivery stage

For more information, see More about Calendar data instances.

Defining reporting requirementsConsider your reporting requirements early in the planning process. Before introducing a new report, answer these questions.

l Does the report already exist? For detailed information about the application-provided reports, see Pega Customer Service Healthcare reports on the Pega Customer Service for Healthcare product page.

l Who needs the report?

l When do they need the report?

l What is the content of the report?

l Why do they need the report?

l Where will it be run? Will it be run in the Pega Customer Service for Healthcare application, or using another reporting tool and source?

With reporting, you should plan your reporting needs ahead of time to give you more flexibility later on.

• Determining reporting architecture

• Reviewing existing reports

• Identifying key metrics

• Identifying dashboard reports

Determining reporting architecture

Determine which reports you are going to generate from the application, and which you are going to generate using a different reporting tool.

To record your decisions during this procedure, use the "Reports" worksheet in the Implementation Planning Workbook.

To understand reporting requirements, see Reporting.


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1. Review the description of each application-provided report, identify the expected volume of data, and determine how often you expect to run each report.

2. Identify other reporting tools at your site.

Reviewing existing reports

The application includes numerous reports. Identify the application-provided reports that meet your business needs.




3. Click the My Reports link.

4. In the Explorer panel, click Reports.

5. Review each of the reports in the Public categories section.

6. Determine who needs the report, what it contains, and when and why it's needed.

Identifying key metrics

Identify key metrics early in the planning process so that you can structure your application to generate the required metrics.


1. Review the list of existing reports with supervisors and managers, sales managers and sales representatives.

2. Identify any metrics that are already provided by the application.

3. Identify metrics that are not already provided by the application.

4. Determine who needs each report, what it contains, and when and why it is needed.


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Identifying dashboard reports

Additional application-provided reports are available from the Dashboard. Identify the application-provided dashboard reports that meet your business needs.




3. Click the Dashboard link on the Home tab.

4. Identify the reports that are relevant to your application, and decide if any report needs to be replaced by a different report.

Building featuresAs you build and modify features, update the Application Specifications to reflect the changes. For instructions, see About Application Specifications.

To build application features, complete the following steps:

• Building a new application

• Integrating data

• Configuring channels

• Configuring dialogs and coaching tips

• Configuring important messages

• Configuring the behavior of additional components

• Modifying the user experience

• Configuring the portal search

• Quality reviews and customer satisfaction surveys

• Customer Decision Hub

• Configuring access groups


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• Configuring reports

Building a new applicationBefore you can implement the Pega Customer Service for Healthcare application, create a new application using an application wizard and then build the application. Building an application includes these steps.

• Enabling automatic service case creation

• Configuring the New menu to test an application

• Configuring application settings

Enabling automatic service case creation

When you create a new application, you must complete some steps to enable the automatic service case creation for Case Designer and to start working with the Interaction Driver. You must create a new data source and an Interaction Driver.

To create these artifacts, complete these steps. Accept any defaults for fields that are not listed.

1. In Designer Studio, click +Create > Data > Customer Service Datasource.

2. Complete the form with the following information and then click Create and open.

Label - Primary

Apply to - Organization-ApplicationName-Work

a. Complete the Detail tab of the Edit Customer Service Datasource form with the following information and then click Save.

Page - Primary

Class - Organization-ApplicationName-Work-Interaction

3. In Designer Studio, click +Create > Process > Interaction Driver.

4. Complete the form with the following information and then click Create and open.

Label - Driver


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Apply to - Organization-ApplicationName-Work-Interaction

5. Complete the form with the following information and then click Save.

Category name - General

Data Source - Primary

Default Category - General (You must save the form first before you can select General)

Configuring the New menu to test an application

The New menu from the Interaction Portal is a useful way to test your application before you integrate your telephony system using Pega Call.

1. In Designer Studio, search for CPMInteractionPortalMenu.

2. Click CPMInteractionPortalMenu from the lone search result.

3. Click Save as.

4. Accept the defaults and click Create and open.

5. Double-click the Phone Call entry.

6. Click Actions.

7. Update the Class Name field to Organization-ApplicationName-Work-Interaction-Call

8. Click OK.

9. Click Save.

Configuring application settings

Pega Customer Service for Healthcare contains several settings that you review and configure to affect the behavior of the application. These settings include automatically refreshing My Work tab, adjusting call volume refresh rate, and enabling Pega Knowledge, Pega Co-Browse, and Pega Customer Decision Hub.



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3. In the Explorer panel, click Settings and then click Behaviors.

4. In the General Settings section of the Behaviors page, ensure that the Auto-refresh My work check box is selected so that each time you open the My Work tab, it is automatically refreshed.

5. If you want to display the Contact Center volume indicator gadget in the Interaction Portal header, select the Display Call volume indicator check box.

Note: An additional configuration is required to reflect the contact center metrics.

6. If you select the Display Call volume indicator check box, the Call Volume refresh rate (secs) list appears. Select how frequently you want to refresh the indicator.

7. From the Messages and Alerts refresh rate (secs) list, select the refresh rate to refresh the Messages and Alerts gadget that notifies the customer service representatives with the number of messages or alerts received.

8. From the Call timer refresh rate (secs) list, select the refresh rate to refresh the call timer. Using the default 1-second rate provides a realistic timer for the Customer Service Representative (CSR).

9. From the Default service request category list, select the default category. The new service case gets displayed in the interaction portal under the Add Task menu.

10. To display relevant articles that help the customer service representatives during an interaction, in the Knowledge section, select the Enable display of knowledge articles check box. There are additional knowledge display configuration options available. For information on additional knowledge configuration option, see the Configuring Pega Knowledge section.

11. To share a browser session with a customer, in the Co-Browse section, select the Enable Co-Browse check box.

12. Complete the Co-Browse token and Co-Browse API key fields.

For more information see, Obtaining the co-browse API key and token in the Pega Co-Browse Implementation Guide on the Pega Customer Service product page.


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13. To display suggestions for the next best action based on the context of the customer, the contact center, and any other contextual information configured in Customer Decision Hub, in the Customer Decision Hub section, select the Enable Customer Decision Hub check box. For additional information, see the Customer Decision Hub product page.

14. If you selected the Enable Customer Decision Hub check box in the previous step, you must complete the Customer Decision Hub server URL field. Contact your Customer Decision Hub administrator to obtain the URL.

15. To connect to the Pega Workforce Intelligence server, in the Workforce Intelligence section, enter the Workforce intelligence server URL. When you enter the server URL, a connection is established between the Pega Customer Service application and the Pega Workforce Intelligenceserver that displays real-time user data on the Workforce Intelligence dashboard. This enables you to gain actionable insights on your team's activity inside Pega Platform and other desktop or browser applications, and also helps to quantify automation opportunities and savings. For more information on the additional configuration settings for Pega Workforce Intelligence, see the Pega Workforce Intelligence product page.

16. To suggest an automated response to the customer service representative, in the Agent Augmentation AI section, select Enable agent augmentation. There are additional Agent Augmentation AI configuration options available. For more information on the additional configurations such as enabling Agent Augmentation AI suggestions for channel capabilities such as common phrases, page push, and knowledge articles, see Configuring the Agent Augmentation AI suggestions.

17. Click Done.

Integrating data To integrate data into a Pega Customer Service for Healthcare application, follow these steps.

1. Generate a data class to connect to your external data.

You can use a connector to a web service or the Database Table Class Mapping wizard for a database.

2. Create a report definition to retrieve the data.

3. Create an Implementation class based on the PegaCA-Interface class that you are implementing.


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4. Update the data pages for that class by changing the sourcing of the data page to the report definition that you created.

5. Create a response data transform for the data page to convert the data class fields to the interface class fields.

6. Repeat this process to populate all of the data pages that you recorded in the plan section.

Here is an example of the process that you follow to load account data from an external database for an application named MyApp.

1. Use the Database Table Class Mapping wizard to generate a data class named MyApp-Data-Account that accesses the external database table with account information.

2. Create a report definition named GetAccountByLastName that returns a list of accounts where the last name is matched with a value entered in the UI.

3. Create an implementation class by doing a save as from the PegaCPMHC-Interface-Account and naming that class MyApp-Int-Account.

4. Update the MyApp-Int-Account data pages (for example, D_Account_Details) to use the report definition that you created.

5. Create a response data transform in the MyApp-Int-Account class to map the Interface and Data classes.


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Note: Pega applications include data types that need to be configured to point to a site's data. You must configure these data types to integrate the site's data source into the application. To configure the data types, go to Designer Studio > Data Model > View external data entities. For more information, see Viewing external data entities.

Configuring channelsA customer service representative communicates with customers through channels and can manage multiple service requests as part of a single customer session. A customer can call into a call center and make several changes to their account without having to speak to several different representatives. Interactions can occur over several different types of channels including those listed below.

l Inbound and Outbound Phone calls

l Chat

l Email

l Social

l Mobile

Complete the following tasks to configure interactions.

• Add Task Menu categories

• Configuring Add Task Menu categories for each channel

• Creating service cases

• Modifying service cases

• Creating an Intent Task

• Creating Intent When rules

• Creating interaction goals

• Creating call duration goals

• Adding data sources

• Configuring suggested work item reviews


Delivery stage


• Configuring common phrases

• Adding and enabling transcript data masks

• Configuring Page push

• Configuring chat queues for Pega Chat

• Configuring suggested Augmented Agent AI responses

Add Task Menu categories

The Add Task menu categories (known as Interaction driver categories in Designer Studio) manages the interaction configuration for a channel. You can toggle settings per interaction type for the following types of properties.

l Coaching tips

l Dialogs

l Chat sayings

l Quick wrap-up

Additionally, you can configure categories to organize the Service Requests performed by the customer service representatives.

Note: Only the categories that are defined in the default driver class property of the specified driver will be displayed in Pega Express. To modify categories that are not listed, switch to Designer Studio.

Configuring Add Task Menu categories for each channel

Add Task menu categories (known as Interaction driver categories in Designer Studio) are already created for each supported channel, including Chat, Child Interaction, Email, Mobile, Phone-inbound, Phone-Outbound, Research and Social.


Follow these steps to modify an existing category.


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2. Click Settings and then click Interactions to see a list of all the task menu category instances for each channel types.

3. Add a category to the channel by supplying the following information.

l Category Name - Name of the category to organize Service Requests.

l Optional: When - When rule used to control if the category displays to a user.

l Behavior - Determines whether this category displays all tasks and suggestions or only tasks, or only suggestions.

4. Add more categories as defined in the Defining requirements section of this guide.

5. Click Save.

Creating service cases

Service cases (known as Case Types in Designer Studio) represent the business transactions that you provide to a customer service representative for execution during an interaction. You can create your service cases based on your business requirement.



2. Click Cases. The list of all available cases is displayed.

3. Click New to create a new service case.

4. Enter the Case type name and then click Next.

5. Add the required fields to your case type. Optionally, if you want to use the existing fields provided by the application, select Show reusable fields, to list all the fields that are available from which you can choose to reuse. For more information, see Pega Platform help.

6. Click Done.


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Modifying service cases

You can modify the existing service cases during an interaction. Modifying a service case can include modifying an existing field in a data source, modifying or adding a stage or step of a case type, or updating a service request option.

Note: You can not edit the views in Express if you open or modify them in the Designer Studio.



2. Click Cases. The list of all the existing cases is displayed.

3. Click on the service case that you want to modify. The editor window is displayed.

4. To add a new data field or to modify an existing field in the data source, click the Data model link. For more information, see Adding fields to your data model.

5. To modify or add a stage or step to the case type, click the Life cycle link. For more information, see Defining a life cycle for a case type.

6. You can configure the behavior of a case type by modifying settings, such as the goal and deadline setting, timeout value for a service-level agreement or the service request options (known as Intent tasks in Designer Studio). For more information, see Adding functionality to a case type.

7. To modify the service request options specific to the application, click the Settings link. For more information, see Editing service request options.

Creating an Intent Task

Intent Tasks (known as Service request options in Pega Express) are used to expose your service cases that you created in the Case Designer to the customer service representatives in the Interaction Portal. When a service case is created, an intent task (Service request option) for the service case is generated. All Intent Tasks generated are placed in the Default service request category of the Express Behaviors page. If you want your service case to appear in a different category you create a new Intent Task for it.

1. Click Designer Studio > Customer Service > Interactions > Intent Task.

2. In the Show Interaction Driver Tasks in field, select All Inherited.


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3. Select the first interaction type in the Show Tasks for Interaction Type field for your application.

4. Click Run.

5. Click Add.

6. Enter the following information in the Add Intent Task form.

l Driver Category - The name of the Interaction Driver Category that the Intent Task should be part of.

l Task Name - The name that will appear to the customer service representative in the Interaction Portal.

l Usage - A description of the task.

l Associated Class - The class name where the Intent Task is created. This should be the interaction class of your application that makes it available for all interaction types.

l Task Class - Enter the class name of the service process for this Intent Class

l Starting Flow - For all service cases built in the Case Designer the value will be pyStartCase.

l Available In Task List - Clear this check box to prevent the task from showing in the list of available tasks in the Interaction Driver.

l Available in Mobile Task List - Choose True to enable the task to be displayed in the list of tasks available in the Mobile driver.

7. Click Add.

To add task suggestions, enter the details under the Task Suggestion section.

Editing service request options

When using Pega Express, you can edit the Service request options (known as Intent Tasks in Designer Studio) based on your requirement.



Delivery stage





4. Click the case that you want to open.

5. Click the Settings tab to open the different editable configurations in the left panel of the window.

6. In the left panel, click Service request options.

The configuration parameters display in the right panel of the window.

7. Click the Change interaction driver category list and select an appropriate category to change the category for the service request.

8. Go to the Suggestion Criteria section, click the Suggest Address Change When list, and then select an appropriate value to edit the existing intent when conditions.

9. Optional: Click Add item to add a new condition or click Delete to delete the existing condition.

Note: You can change categories only when the intent is available in an unlocked ruleset.

10. When you are finished editing all of the required parameters, click Save.

11. Repeat steps 3 through 9 for each Service request that you want to edit in your application.

Creating Intent When rules

Intent When rules are used by Intent Tasks (known as Service request options in Pega Express) to determine when tasks should be suggested, queued, or automatically launched.


2. In the Explorer panel, click Records, then expand Decision.

3. Right-click Intent When and select +Create.

4. Complete the following information.


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l Label - The name for your Intent When rule.

l Apply To - This should be your interaction class, for example MyApp-Work-Interaction.

l Add to ruleset - An open ruleset to save the rule to.

5. Click Create and open.

6. Configure the Intent When rule by using one or more conditions.

l Label - The name of the condition which you will use in the criteria logic

l DataSource - The data source to use.

l Field- The property from the data source to use.

l Operation - The comparison operation.

l Value - The value to compare the field against.

7. Use the labels from your conditions to complete the criteria logic, for example (a and b).

You can also configure the auto launch of a service process at the start of an interaction based on a When condition defined in the Criteria tab. For more information, see Configuring the Auto-Launch of Intent Tasks.

Creating interaction goals

Interaction goals help guide a customer service representative during an interaction. An interaction goal is the overall goal for a particular customer interaction and guides the outcome of the interaction toward a desired resolution. For example, if a company knows that a customer is dissatisfied, an interaction goal of remediate can trigger certain offers or tasks to make the customer happy, such as waiving a fee. Suggested offers or tasks are displayed in the Next Best Action section of the Interaction Portal during a service request.

To display the current interaction goal, the Interaction Portal uses the InteractionGoal property located in MyApp-Work-Interaction. The InteractionGoal property uses a declare expression to load the correct value from the DetermineInteractionGoal decision table. When you create a new application, a blank DetermineInteractionGoal decision table is created for you. You need to populate it based on the information from the Defining the interaction goals procedure.

To populate the decision table, follow these steps.


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3. Click Decision > Decision Table.

4. In the Purpose* field, click the filter icon and enter DetermineInteractionGoal in the Search Text box.

5. Click Apply.

6. Click each instance of DetermineInteractionGoal in the results list.

7. Update the decision table.

8. Click Save as.

9. Specify your class, MyApp-Work-Interaction, ruleset, and version.


11. Click Save.

Creating call duration goals

Call duration goals guide a customer service representative during an interaction. They are used to communicate the speed at which an interaction can be configured to reflect the needs of their customers based on attributes, such as customer value, number of years with your business, or other variables that help to set the call duration goal.

To display the current call duration goal, the Interaction Portal uses the CallDurationGoal property located in MyApp-Work-Interaction. The CallDurationGoal property uses a declare expression to load the correct value from the DetermineCallDurationGoal decision table. When you create a new application, a blank DetermineCallDurationGoal decision table is created for you. You must populate it based on the information from the Defining the call duration goal process.

To populate the decision table, follow these steps.



3. Click Decision > Decision Table.


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4. In the Purpose* field, click the filter icon and enter DetermineCallDurationGoal in the Search Text box.

5. Click Apply.

6. Click DetermineCallDurationGoal in the results list.

7. Update the decision table.

8. Click Save as.

9. Specify your class, MyApp-Work-Interaction, ruleset, and version.


11. Click Save.

Adding data sources

Pega Customer Service for Healthcare uses data source rules extensively throughout the system. Data sources are used to abstract class, clipboard references, and other parameters to simplify the configuration. A new data source rule is required if you create a new data type and want to utilize the related fields in the following scenarios:

l Interaction driver tasks and suggestions

l Composite displays

l Data references within dialog scripts

l Portal search data retrieval and display



3. Click Data > Customer Service Datasource.

4. Select an instance and complete the fields described in the following steps to save the instance to your ruleset.

5. In the Detail tab enter the following details.


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a. Click the Source list and select one of the following from the list.

l Clipboard Page to specify the associated Page, Class, and related Property fields information required for this data source (see associated fields below).

l Data Page to refresh the rule form and display the Data Page field (Smart Prompt) to specify the desired data page rule for this data source.

b. Click the Page field and enter the name of the clipboard page to use for this data source.

c. Click the Class field and enter the class of the clipboard page given in the Page field.

d. Optional: Enter .pxResults in the Property field, if you selected List in the Type field.

e. Optional: Enter the class of the .pxResults list in the Property class field, if you selected List in the Type field.

f. Click the Type list and select an option.

g. Select the Dialog data source check box to indicate that the data source can be used for data references within dialog scripts. This field is evaluated to populate the data source selection field when configuring dialog scripts using the Configuration Tools wizard.

h. Select the Phrase Data Source check box to indicate that the data source can be used for data references within Chat phrases. Properties defined in this data source are available in the Configure Phrases capability in the Manager Tools page (requires the PegaCA:Manager role).

i. Select the Use as Favorite check box to determine whether this data source type can be used as a favorite in the My Favorites gadget. The Add to Favorites button in the UI is seen for this data source in case portals.

j. Select the Favorite Keys property associated with the data source that you are creating, for example, Contact use .ContactId.

6. In the Properties tab, enter the appropriate value in the Property field.

Properties included on this tab are used to populate the list of available fields that users can insert into dialog scripts using the Configuration Tools wizard. These properties are made available wherever the data source is referenced, such as dialog scripts and chat phrases.

7. In the Search tab, enter the following details.


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a. Select the Use in portal search? check box to indicate that this data source should be searched as part of a portal search.

b. Select the integration activity to use to perform the search operation in the Search activity field.

8. In the Retrieval tab, enter the following details.

a. Click the Default interaction container field and specify the name of the class to use as the default interaction class when a user selects a result from the portal search results list.

b. Click the Interaction Flow field and specify the name of the interaction flow that describes the starting flow to launch a Research interaction.

Note: Supported in legacy portal only (before 7.13).

Editing data source rules

You can personalize and edit the dialogs and common phrases for the data source rules and their related fields during a customer interaction.



3. In the Explorer panel, click Data and then select the data type that you want to edit.

4. On the data page, click Settings > Data source options.

5. From the Select the data source category list, select the data source. The configured fields appear for editing.

6. To add the fields that are configured for the data source rule for dialogs or common phrases, you can select either Dialog or Common phrases check box.

Note: The data source rules that are specific to dialogs cannot be used for common phrases so for those dialog data types, the common phrases check box is disabled.

7. To add a field, click Add new and select a field name from the list.

8. Optional: to delete a pre-configured field, click the delete icon.


Delivery stage

Configuring suggested work item reviews

During customer interactions, Pega Customer Service for Healthcare can suggest the review of a pending work item to a CSR. To configure the suggested work item review, copy the CAReviewServiceItems rule from the PegaAppCA ruleset to your application ruleset and configure the rule based on your business requirements. For more information, see Configuring suggested work item reviews.

Configuring common phrases

Common phrases are frequently used phrases that are displayed in the Pega Chat or Pega Social channel window, such as Twitter, during an interaction. During an interaction, the customer service representatives clicks the Phrases link and selects the configured phrases to display to the customers. This helps to reduce the average handle time of the social interactions.

Adding and editing categories

The common phrases that are used as during a chat or social interaction, are categorized into different categories based on their usage. You can add a new category or edit an existing category from the Common phrases page. When a customer service representatives clicks to add a phrase during an interaction, the categories are listed from where he can select the phrase to use.


2. In the Explorer panel, click Tools > Common phrases.

3. On the Common phrases page, to add, delete or modify a category, click Edit Categories. The Edit categories dialog opens. l To add a category, click Add Category and enter the name of the category in the empty field,

then click Submit.

l To modify a category, change the value of the selected category and then click Submit. The updated category is displayed to the customer service representative.

l To delete a category, click the Delete icon and then click Submit. Deleting a category deletes the common phrases added to it.

To view a specific category, click Display all categories list and select your category. The category and the common phrases of that category is displayed on the page.


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Adding and editing Common phrases

Common phrases can be grouped into categories based on the usage and these categories are displayed in the chat interaction window for the customer service representatives to add the phrase.



3. In the Explorer panel, click Tools > Common phrases.

4. To add a phrase, on the Common phrases page click Add phrase.

5. On the Add phrase dialog, complete the following fields: a. Phrase name - The short indicative name of the common phrase that you want to add.

b. Phrase category - The category to which the common phrase belongs.

c. Language - The language in which the common phrase is displayed.

d. Channel - The channel where the customer service representative add common phrases. It can be a chat channel, a social channel, or both.

e. Phrase text - The complete text that you want to display as a common phrase in the channel window.

6. Optional: To append existing sample text to the new phrase that is created, on the Configure phrase dialog, choose the following and click Append: a. Refer to - Select an existing phrase from the list.

b. Attribute - Select an attribute from the list.

7. To save your changes, click Submit.

Editing a common phrase

To edit a common phrase, click the Gear icon and modify the values in the Edit phrase dialog and then click Submit.

Deleting a common phrase

To delete a common phrase, click the Delete icon and then click Save. Deleting removes the phrase permanently from the category list.


Delivery stage

Adding and enabling transcript data masks

The chat interaction and the related history logs can contain sensitive data such as credit cards, phone numbers, and Social Security numbers. With the Pega Chat application, you can hide this data and mask it in transcripts that are shared with a customer service representative (CSR). The sensitive data is masked to ensure that the confidential information is not displayed in interaction scripts or emails and is not stored in a database.

When you add a mask to the interaction scripts, the user-entered values are masked in the configured format, for example XXX-XX-NNNN for Social Security number. You can enable or disable a mask based on your business needs.


2. In the Explorer panel, click Tools > Transcript data masks.

3. To add a new mask, click Add mask.

4. If you want to enable the mask, select Enable this mask. The Mask enabled column displays a green tick mark that indicates the mask is enabled.

5. In the Add chat mask dialog, enter the values for the required fields and click Submit.

6. If the data entered has special characters, in Add chat mask dialog, enable Advanced mode and enter the validation masks in Validation regex.

7. Optional: To test and validate the configuration, enter the sample text under Test your validation field and click Test. Verify that the correct result is displayed in the Validation format field.

If you want to disable an existing mask, select the mask from the list and click the Gear icon. In the Edit chat mask dialog, deselect Enable this mask. The Mask enabled column displays a cross mark that indicates the mask as disabled.

Configuring Page push

During a chat interaction, the customer service representative can redirect a customer to an online content for further reference. Configuring page push enables the customer service representative to click the Page push link and select the appropriate link to send to the customer.


Delivery stage

Adding and editing categories

The Page push URLs that are used during a chat interaction, are categorized into different categories based on their usage. You can add a new category or edit an existing category from the Page push page. When a customer service representative clicks on the Page push link to add a Page push URL, the categories are listed and the representative can select the one to use for the URL.


2. In the Explorer panel, click Tools > Page push.

3. On the Page push page, to add, delete, or modify a category, click Edit Categories. The Edit categories dialog opens. l To add a category, click Add new and enter the name of the category in the empty field, then

click Submit.

l To modify a category, change the value of the selected category and then click Submit. The updated category is displayed to the customer service representative.

l To delete a category, click the Delete icon and then click Submit. Deleting a category deletes the Page push URLs that have been added to it.

To view a specific category, click the Display all categories list and select a category. The category and the URLs associated with that category display on the page.

Adding and editing URL

The Page push URLs can be grouped into categories based on their relevance. These categories are displayed in the chat interaction window when the customer service representative clicks the Page push link.

To configure page push, perform the following steps:


2. In the Explorer panel, click Tools > Page push.

3. To add a new URL, click Add URL.

4. In the Add URL page, enter the values of all required fields.

5. Click Submit.


Delivery stage

Editing an existing URL

To edit an existing URL, click the Gear icon of the URL and modify the values in the Edit URL dialog, then click Submit.

Deleting a URL

To delete an existing URL, click the Delete icon of the URL and then click Save. Deleting the URL removes the phrase permanently from the category list.

Configuring chat queues for Pega Chat

With Pega Chat, a Customer Service Representative (CSR) interacts with customers from your website by sending and receiving chat messages. Chat queues for a chat server define the skills, schedule, and system generated pre-chat questions. Creating a new chat queue and configuring it to a chat server channelizes the interaction request.

To add a new chat queue and configure it to a chat server, perform the following steps:


2. In the Explorer panel, click Tools > Queue configuration.

3. To view the available queues of a chat server and to add a new queue, select the chat server. The list of available queues display.

4. To add a new queue, click Add new.

5. In the Add a new queue dialog, enter the Queue name, for example, Billing.

6. To enter the skills that are required for the queue, on the Mapping & skills tab, click Add new and identify the skills that a customer service representative must have in order to accept chat requests for this queue. You can select an existing skill or create a new one. Chat requests in the queue are routed to customer service representatives who have all of the listed skills. For example, if a queue requires English speaking representatives who have the skills to process service requests, you might identify a skill for English and another for Service. Chat requests to the queue are routed to customer service representatives who have both skills – English and Service. Create additional skills as needed to meet the needs of the queue. The new skills must match the desired operators skills that is defined in the operators skill section.


Delivery stage

For more information see, Defining the operator skills. In order for the updated information to be available during a chat session, you must synchronize the chat server with the Pega Platform.

7. Optional: Enter the URL pattern for the chat queue. The URL pattern of the organization determines which chat queue should be selected when the request is raised. For example, a banking organization has two divisions, Savings and Credit Card. For Queue A, if the Credit Card URL is configured, then the request raised from that URL will be routed to Queue A.

8. On the Hours of operation tab, select a calendar that reflects the hours of operation of a queue. For information about defining calendars, see Defining the operator attributes. In order for the updated information to be available during a chat session, you must synchronize the chat server with the Pega Platform.

9. On the Wait time and SLA tab, complete the following: a. Off-hours behavior - enter a message to display to a customer who requests to chat when

the queue is not in service.

b. Agents not available - enter a message to display to a customer who requests to chat when no representatives are logged in who can serve the queue.

c. Service level - enter your service level goal by identifying what percent of customers you want to respond to within a selected number of seconds. For example, you might want to respond to 75% of customers within 60 seconds of their chat request. These goal numbers are used for reporting, and are not enforced.

d. In the Wait time section, complete the following fields: l Maximum wait time (Secs) - enter the maximum wait time in seconds for the calculated

wait time on the server. If the calculated wait time is more than this value then chat becomes unavailable.

l Default wait time (Secs) - enter the default wait time in seconds for a queue. If the wait time calculation threshold is not met and if there are customer service representatives available to serve customers then the chat server returns this value.

l Chat offer timeout - enter the time limit in seconds for a customer service representatives to either accept or decline a chat request. After this value is exceeded, the chat expires.

10. To add pre-chat questions, on the Pre-chat questions tab, click Add new and enter the name of the property and the pre-chat question that will be presented to the customer.


Delivery stage

11. To add more chat queues, repeat all of the above steps.

12. Click Save.

Configuring suggested Augmented Agent AI responses

The Augmented Agent AI suggests relevant responses to a customer service representative by analyzing the customer inputs in the chat interaction and determining if content is available in the knowledge articles, common phrases, or page push entries. Every suggestion made to a customer support representative is given a score by the Customer Decision Hub, based on its relevance to the customer input in the chat session. The suggestions are made to the customer service representatives when the confidence threshold score is exceeded. If the score is below the threshold value then the suggestion is not made.

Note: Enable Customer Decision Hub to use the Augmented Agent AI capability. Customer Decision Hub is licensed separately. For more information on enabling Customer Decision Hub, see Customer Decision Hub

To enable Augmented Agent AI suggestion for channel capabilities such as common phrases, page push, and knowledge articles, perform the following steps:


2. In the Explorer panel, click Settings and then click Behaviors.

3. In the Agent Augmentation AI section, select Enable agent augmentation.

Note: Enable either of the Common phrases, page push, or Knowledge articles content source so that Agent Augmentation can make a suggestion.

The following configuring options appear: a. Suggest content to agents at - The slider value determines the minimum value level

before the suggestions are made to customer service representatives.

b. Common phrases - Enabling this option instructs the AI to consider the list of Common phrases that is applicable to the chat channel and displays pre-configured phrases to the customer service representatives.

c. Page push - Enabling this option instructs the AI to consider page push entries and allows the customer service representatives to redirect the customers to a pre-configured destination, such as a web page or help site, during an interaction.


Delivery stage

d. Knowledge articles - Enabling this option inserts relevant Pega Knowledge articles as suggested references into the chat conversation.

e. Allow auto-response - Enabling this option triggers the Customer Decision Hub to send automatic suggestions as responses when the highest confidence score is reached. A customer service representative cannot edit or cancel a response before it is sent.

4. Click Done.

Configuring dialogs and coaching tipsDialogs and coaching tips help the support representative to provide the best possible experience for the customer.

It is recommended that you use Interaction Portal for creating or modifying the dialogs and coaching tips.

Note: To create or modify a dialog or coaching tip, ensure that you update the DialogCoachingTipRS property with an unlocked ruleset name that is meant for saving dialogs and coaching tips in the CSGeneralSettings data transform.

You can configure dialogs and coaching tips with the following methods.

• Creating or editing dialogs

• Creating or editing coaching tips

Creating or editing dialogs

Dialog suggests scripting to the customer service representative when they interact with customers to resolve an issue or question and also ensures that a consistent message is delivered to the other similar customer interactions.

1. Log in to the Interaction Portal.

2. Click +New > Demo Screen Pops > Demo Pop to make a demo call.

3. Open a task that you want to work on from Add Task or Next best action menu, for example, Dispute Transaction.

4. Click More options > Configuration Tools.


Delivery stage

The Configuration tools dialog opens.

5. On the Dialogs tab, click Add new to add a new dialog. Otherwise click the edit icon to edit the existing dialog.

6. Select the appropriate condition from the When list, if you want to display the dialog in a certain circumstance. Otherwise select Default.

7. Optional: To personalize the dialogs, perform the following steps.

a. Select a value from the Refer to list, for example, Contact.

b. Select an appropriate value from the Attribute list, for example, Last name, to display the last name of the contact.

c. Click Insert.

The selected values are displayed in the Dialog field.

8. Enter an appropriate message in the Dialog field, for example, which transaction were you concerned about?

9. Click Save.

Creating or editing coaching tips

Coaching tips provide tips or specific advice to customer service representatives about a specific step in a service case. A new coaching tips can be assigned to a specific workgroup or customer service representative and may need a reminder or other coaching.

1. Open the Configuration tools dialog and click the Coaching tips tab.

2. Expand Manage and click Add new to add a new coaching tip. Otherwise click the edit icon to edit the existing tip.

3. Enter a value in the Name field, for example, Empathize.

4. Enter the tip that you want to convey to the CSR in the Coaching tip field.

5. Expand Assign and click Assign a tip.

6. Select a coaching tip from the Coaching tip list that you want to assign to the specific workgroup.


Delivery stage

7. Select the specific workgroup or operator from the Assign to list.

8. Click the From field and select a date from when you want to display the tip.

9. Click the To field and select a date until you want to display the tip.

10. Click Save.

Configuring important messagesPega Customer Service for Healthcare includes Important Messages, a re-usable process that you use to quickly set up mobile push notifications, proactive emails, and self-service messages from within a case. You can add this process to any case in your application. For example, when an appeal decision has been reached, Pega Customer Service for Healthcare can send a mobile push notification to the customer.

1. In the Designer Studio Explorer panel, click App, and in the search field, enter PegaCPMHC-Work.

2. Save the CreateImportantMessages flow from Pega-CPMHC-Work into the class of your case.


4. Click a case type to which you are adding the CreateImportantMessages process.

5. On the Edit case type page, in the selected stage where you want the process to occur, click the arrow at the right of the stage name, and select Add process.

6. In the text field that appears, replace the text with text such as Create Important Messages.

7. Delete the default process that appears below the step.

8. Click Save.

9. In the +Step field, click More.

10. In the Search field, enter Create Important Messages.

11. Click the item in the Search results.

12. In the tab that appears at the right, click Open process.

13. Add the Subprocess icon to the flow.


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14. In the Subprocess properties dialog box, complete the following fields.

a. In the Subprocess field, enter the name of the subprocess.

b. In the Flow name field, click to select CreateImportantMessages from the list.

c. Complete the CustomerID and the EmailID fields with information for the individual who will receive the important messages for this case.

d. Click Submit.

15. Save and check in the subprocess.

16. Reopen the case and refresh it to view the subprocess.

Configuring the behavior of additional componentsPega provides various additional components also known as channels. A channel is a means of communication that a customer uses to interact with a company. Pega Customer Service for Healthcare includes integrated, multi-channel support capabilities for managing telephone, web chat, e-mail, and web-based service interactions. In addition, in-person interactions may be conducted using a mobile device such as a tablet computer.

With Pega Customer Service for Healthcare, you can build your process once and reuse it in any channel, thereby saving time and money while improving consistency in today’s multi-channel contact centers.

Use the following topics to configure your channels:

• Configuring Pega Call

• Configuring Pega Co-Browse

• Configuring Pega Chat

• Configuring voice and data transfer for Pega Call

• Configuring Pega Social

• Configuring Pega Knowledge

• Configuring Email

• Tablet support


Delivery stage

• Web self-service

• Configuring anonymous customer interactions

Configuring Pega Call

Pega Call provides robust Computer Telephony Integration (CTI) support including adaptive screen pops, desktop telephony controls, and enhanced callout facilities. By using the business rules engine architecture, service cases and dialogs can be reused across channels from Interactive Voice Response (IVR) to the web. Use Pega Customer Service for Healthcare with Pega Call to leverage the voice and data transfer capability.

For information about how to configure voice and data transfer for Pega Call, see Configuring voice and data transfer for Pega Call.

For more information about configuring Pega Call, see the Pega Call product page.

Configuring Pega Co-Browse

With Pega Co-Browse, your customers and agents collaborate by sharing a web browser session on the customer's PC, tablet, or mobile phone.




3. In the Explorer panel, click Settings > Behaviors.

4. Select the Enable Co-browse check box.

5. Complete the Co-Browse token and Co-Browse API key fields.

For more information see, Obtaining the co-browse API key and token in the Pega Co-Browse Implementation Guide on the Pega Customer Service product page.

6. Optional: If you want to use Co-Browse recording capability, select the Enable Co-Browse recording playback check box.

7. Click Save.


Delivery stage




Configuring Pega Chat

Customers can implement Pega Chat at the same time as Pega Customer Service for Healthcare, or they can add this component later.

For information about how to configure Pega Chat, see Pega Chat implementation.

Configuring voice and data transfer for Pega Call

You can transfer a call to another CSR along with the associated interactions using voice and data transfer. When you transfer a call with the associated interaction, the associated service cases are also transferred. Use Pega provided telephony toolbar to transfer the call.

Note: To transfer a call, ensure that the CSR is logged into the same portal and use the same navigation method.

Voice and data transfer supports both warm and blind transfers.

Before you configure and use voice and data transfer, ensure that Pega Call is installed, configured, and connected to a CTI platform that supports adding call data elements to a call.

Perform the following tasks to configure voice and data transfer.

• Enabling the Transfer tool

• Enabling the Accept button on the Review Harness

• Transfer reasons

• Setting a time limit for voice and data transfers

Enabling the Transfer tool

To enable the voice and data transfer, ensure that you configure the telephony toolbar, and then select a mode (Full telephony, Simple telephony, or Simple telephony with agent state) with integrated voice data transfer option enabled. For more information, see the CTI server-specific guide available on PDN.

Enabling the Accept button on the Review Harness

For warm transfers, the receiving party can view the interaction or service process in a Review harness during the consultation call. After the call transfer is complete, click Accept on the harness to open and continue processing the interaction and related service cases.


Delivery stage

The Review harness provided in PegaCA-Work and PegaCA-Work-Interaction include the Accept button. If you have customized the Review harness in PegaCA-Work-Interaction, ensure that the PegaCA-Work.CPMWarmTransferAcceptButton section is included in your custom harness.

In addition, if you use Classic navigation and customized the Review harness for a service process, ensure that it includes the PegaCA-Work.CPMWarmTransferAcceptButton section.

Transfer reasons

When transferring a call with its associated interaction, you can select a reason for the transfer. The reasons are listed in the ChannelServices-Device-Phone-UI.pyCPMTransferReason property. Save the property to your ruleset and modify the table values to suit your needs.

Setting a time limit for voice and data transfers

Configure a time limit beyond which work objects in the transfer workbasket are moved back to the user who initiated the transfer. The PegaCS default time is set to 15 minutes in an activity rule.

1. In the Explorer panel, click App and enter PegaCA-Work in the search field.

2. Click Technical > Activity > CACTIReassignToTransferor.

3. Click Save As to save the activity to your ruleset.

4. On the Steps tab, expand Step 1.

5. Update the PropertiesValue for the param.TimeDiff2 property. The last two parameters of the @addToDate value represent minutes and seconds.

Ensure that you update the values as negative integers to reflect the desired transfer time in minutes and seconds.

6. Click Save.

Enable the ReassignToTransferor Agent, which is included in the PegaAppCA Agents rule to run the activity periodically. If you modify the activity in your custom ruleset, ensure that the service package used by that rule can access your ruleset.

Configuring Pega Social

Customers can implement Pega Social at the same time as Pega Customer Service for Healthcare, or they can add this component later.

For more information about how to configure Pega Social, see Pega Social configuration .


Delivery stage

Configuring Pega Knowledge

Configure Pega Knowledge articles to suggest the relevant content to customer service representatives while working on a specific service case. This saves the time of customer service representative to search answers for customer questions and issues and reply them quickly. You must create and publish articles in the Pega Knowledge application before linking them to the service requests using the Configuration Tools capability in the interaction portal. Log in as CAManager to link the articles, for more information, see Linking knowledge content articles.

To configure the display of knowledge articles, perform the following steps:



3. In the Explorer panel, click Settings > Behaviors.

4. Select the Enable Display of Knowledge articles check box.

5. Select the Limit the number of suggested articles check box to restrict the number of articles displayed in the Knowledge Management Suggested articles section in the Interaction Portal. Specify the maximum number of articles that you want to display in the Suggested articles, Other relevant articles, and Articles viewed by the customer sections. By default, 3 articles are displayed in the interaction portal. Clearing this check box removes the display restrictions and provides pagination and scrolling capabilities to navigate additional articles in these sections.

6. Select the following options under Article push options for chat: a. Insert as link - Enabling this option allows the customer service representative to push the

in-context knowledge article into the chat transcript as a clickable link.

b. Share abstract? - Enabling this option inserts the article abstract into the chat window.

c. Insert as text - Enabling this option allows the customer service representative to insert the article into the chat window as plain text.

Configuring article push for chat supports the display of a Pega Knowledge content link, content text, or both link and text in a chat window that is configured for service requests during an interaction.

7. To save your configurations, click Done.


Delivery stage

Linking Knowledge content articles

You can link Pega Knowledge articles directly to service cases. These links serve as suggestions to customer service representatives for quick, contextual answers that expedite customer issue resolutions.

Use the Interaction Portal for linking the articles to a flow action of a service case.

Note: To link or unlink an article, ensure you update the DialogCoachingTipRS property with any unlocked ruleset name.

To configure the articles, follow these steps.

1. Log in to the Interaction Portal as an operator with manager role credentials.

2. Click New > Demo Screen Pops > Demo Pop to make a demo call.

3. Open a task that you want to work on from the Add Task or Next best action menu, for example, Dispute Transaction.

4. Click the More options > Configuration Tools. The Configuration tools dialog opens.

5. On the Knowledge Content tab, under Search articles to add field, search for articles by entering the article key word already created in Pega Knowledge. The search results are displayed.

6. Select the desired article from the list and then click Save. The articles that are linked are displayed under the Suggested articles section.

To unlink an article, click the Unlink article icon and then click Save.

While linking articles for the first time, all the articles are copied to the rest of the flow actions in that service case. You can select different articles at on each step or flow action of a service case.

Configuring Email

You can configure Pega Customer Service for Healthcare to create correspondence cases from inbound email messages and respond to customer inquiries by using outbound email.

Complete the following tasks to configure email.

1. Update an email account.

2. Create an email channel from the landing page.

3. Set up the email channel


Delivery stage

Updating an email account


2. Click Records > Integration-Resources > Email Account> SmartEmailSample.

3. Click Save > Save As to create a new account.

You can modify the sample email account for your own needs, or you can duplicate it using Save As if you plan to create multiple email accounts and corresponding interaction channels. For more information about email accounts, see the Pega Platform help.

Creating an email channel from the landing page

You can use the email channel in your application to route emails received from email accounts to operators and workbaskets. You can configure the email channel in your application by clicking the Application menu > Channels and Interfaces > Email.

To create an email channel for your application, perform the steps provided in the Configuring the email channel.

Setting up an email listener

The email listener uses the email server to periodically search for new inbound email messages. If the listener finds emails, it directs them appropriately for your application.


2. Click Designer Studio > Integration > Email > Email Wizard.

3. Complete the fields in the Enter Email Information section and click Next. For detailed information about field content and options, see the Pega Platform help.

4. Complete the fields in the Inbound Email section and click Next. For detailed information about field content and options, see the Pega Platform help.

You can use the standard EmailDefault service package shipped with Pega Customer Service for Healthcare, which specifies an access group that includes the appropriate ruleset to function properly. If you are using a different service package, make sure that its access groups include Pega Customer Service for Healthcare rulesets. Specify the default Service Method called AddWorkItemForEmail. This method automatically creates Inbound Correspondence cases for inbound email.


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https://pdn.pega.com/sites/pdn.pega.com/files/help_v731/procomhelpmain.htm#data-/data-emailaccount/new.htm?Highlight=email account

https://pdn.pega.com/sites/pdn.pega.com/files/help_v731/procomhelpmain.htm#mcp/tasks/mcp-configure-email-channel-tsk.htm

https://pdn.pega.com/sites/pdn.pega.com/files/help_v731/procomhelpmain.htm#mcp/tasks/mcp-configure-email-channel-tsk.htm

5. Create additional listeners for each account being monitored.

Tablet support

Pega Customer Service for Healthcare provides a touch-friendly user experience for service personnel using tablets. Using Pega Customer Service for Healthcare from a tablet browser, a user may initiate interactions, access customer information (composites), and serve customers using service cases. Users may also access cases from workbaskets and work lists to assist with customer service.

Consider the following topics when building for a tablet.

• Differences between tablet and desktop portals

• Responsive UI

• Interaction class and Interaction Driver

• Rule specialization for a tablet

Differences between tablet and desktop portals

Pega Customer Service for Healthcare provides access to most of the capabilities available on user desktops. However, various elements have been optimized for the use cases typically encountered on a tablet. The following are some key differences between the tablet portal and the interaction portal.

l Slide-out menu : To provide a touch-friendly navigation experience, various items that are presented in separate tabs on the desktop are accessed from a slide-out menu in the tablet portal. This includes the dashboard, workbaskets and work lists, and interactions in progress.

l Service processes and suggestions: Service processes, suggested service processes, and offers are presented at the top of the interaction area. The current service process is shown in blue with a star icon. Completed service processes are shown in blue with a check icon. Offers and suggestions are shown in gray.

l No customer validation: Customer validation is not included in the default interaction flow.

l Dialog and coaching tips: Dialog and coaching are not enabled for tablet interactions, as these are typically in-person interactions.


Delivery stage

l Quick wrap-up: Tablet interactions do not include an explicit wrap-up stage. The interaction may be closed quickly using the Close button. Any service-case that is open as part of the interaction will remain assigned to the users and can be accessed from their respective work list.

l Chat and CTI support: Telephony integration (Pega Call) and web chat (Pega Chat) integration are not available on tablets.

Responsive UI

The tablet portal uses responsive UI design techniques to ensure that UI elements and screens are rendered appropriately on a tablet. While developing UI for composites and service processes, you should use Pega Platform layouts and the application skin to ensure that screens are rendered appropriately on the smaller screen sizes typical of tablets. Where required, UI elements may also be specifically adapted for tablets using rule-specialization techniques such as circumstancing, as described in the next section.

Interaction class and Interaction Driver

Interactions performed on tablets use the interaction class PegaCPMHC-Work-Interaction-Mobile. Various rules related to interaction management have been specialized in this class. You should ensure that your tablet interaction class inherits from PegaCPMHC-Work-Interaction-Mobile.

The tablet interaction class includes an Interaction Driver rule specialized for tablets. By default, dialog and coaching tips are turned off for tablet portal interactions. Quick wrap-up is enabled.

The tablet interaction class includes a version of the AppVerifyContact flow that does not require verification of the contact.

Note: Intent Task rules include a Show in List of Available Mobile Tasks? check box. This check box is no longer used. The mobile Interaction Driver does not filter Intent Tasks (suggested tasks) based on this check box.

Rule specialization for a tablet

When required, rules are specialized to provide a more touch-friendly experience. Rules that are part of the Interaction Portal (apply to CPM-Portal) and those that apply to Pega Customer Service for Healthcare work classes (for example, PegaCPMHC-Work) are specialized by circumstancing, as described below. Rules that are part of the interaction class (for example, PegaCPMHC-Work-Interaction) are specialized by class – by creating a specialized rule in the Interaction-Mobile subclass (for example, PegaCPMHC-Work-Interaction-Mobile) class.


Delivery stage

Rule Circumstancing using CPMPortalType: Pega Customer Service for Healthcare uses the circumstance template CPMPortalType to determine when the Pega Customer Service for Healthcare interaction portal is being accessed from a tablet. Various UI rules (in class CPM-Portal) are circumstanced to specialize them for tablets, that is when CPMPortalType = CPMInteractionMobilePortal. For example, the New work menu (CPMInteractionPortalMenu navigation rule) has been circumstanced so that only tablet interactions may be created using the New menu.

The following rules have been circumstanced.

l Mobile Interaction Portal Harness: The CPMInteractionPortal harness has been circumstanced to provide touch-friendly portal behavior. Note that the harness includes various sections that are similarly circumstanced.

Note: When reviewing the harness and related UI rules, note that Designer Studio displays the base version of each included rule rather than the one circumstanced for use on tablets. To review the circumstanced version of a rule, select View Versions from the Actions menu and select the circumstanced version. At run time, the circumstanced versions will be rendered.

l Slide-out menu: The circumstanced version of the CPMInteractionPortal harness uses a HeaderLeft screen layout. In the application skin, this layout includes a responsive breakpoint for the left sidebar so it is presented as a slide-out menu at screen sizes typical of tablets.

l Tablet Dashboard: The CPMDashboard section and associated sections have been circumstanced to ensure that they render appropriately on tablets. The dashboard uses two charts (rather than three on the desktop portal) to ensure that content fits at lower screen sizes. In addition, the user’s work list and workbaskets are not displayed on the dashboard.

Web self-service

The availability of the service cases that you create is not limited to the Interaction Portal. You can use Pega Web Mashup to embed the cases you create into another application.

Configuring anonymous customer interactions

Customer service representatives often interact with users who are not identified as customers in the database. The users might call, chat, or post on Facebook to seek information about a new product. In such cases, a customer service representative does not need to pull up a contact or account information to reply to general enquiries from these users. The anonymous customer interactions functionality helps customer service representatives assist customers who are not identified in the application through chat, email, phone, or social channels. Customer service representatives can


Delivery stage


assist anonymous customers using the following tabs: Search, General assistance, and New customer.

1. To start an interaction with customers based on the channel of your choice, you can configure any of the following three tabs Search, General assistance, and New customer to be active. For example, to start the Chat channel on the GeneralAssistance tab, perform the following steps:

a. In the Designer Studio Explorer panel, click App, and in the search filed, enter PegaCA-Work-Interaction.

b. Click Chat > data model > data transform > pyDefault.

c. Click Save as to save the rule in your open ruleset.

d. In the Label field, enter a name, and then click Create and open.

e. In the Source field of the .DefaultTabInSearchScreen row, enter GeneralAssistance.

f. Click Save.

g. Repeat steps 1a to 1f for each of the channels that you want to modify.

2. By default, the anonymous customer functionality is enabled. You can disable the General assistance, and New customer tabs by performing the following steps:

a. In Designer Studio, in the search field, enter and select CSInteractionSettings.

b. Click Save as to save the rule in your open ruleset.

c. In the Label field, enter a name, and then click Create and open.

d. In the Source field of the .EnableAnonymousInteractions row, enter false.

e. Click Save.

Notes: You cannot disable the Search functionality.

Modifying the user experienceThere are multiple places where you can change the user interface of the Interaction Portal. Each location that you want to update follows a similar process.

• Modifying the user interface element to change


Delivery stage

• Implementing user interface changes to the Interaction Portal

Note: As you implement changes to the user interface, make sure that end users test the changes. Do not wait until the end of a project to perform the testing because it costs more to make a change at the end of the release cycle.

Modifying the user interface element to change

You can update the user interface experience from the Interaction Portal to reflect the style of your business.

1. Click the Live UI icon .

2. Select the element that want to change.

When an element is selected, Live UI provides information about that element, such as the sections and harnesses that the element is a part of.

3. Click the Open rule in Designer Studio icon to open that rule in Designer Studio and update it as needed.

Implementing user interface changes to the Interaction Portal

The application supports the following changes to the Interaction Portal.

• Adding a new property to a section

• Adding a new section to the Interaction Portal

• Updating the Interaction Portal skin

• Configuring Interaction Portal tabs

• Launching a service case from the composite

• Logging an event during an interaction

• Changing the home page reports

Adding a new property to a section


Delivery stage

1. In the Interaction Portal, click the Live UI icon and determine the section that you want to modify.

2. Click the Open rule in Designer Studio icon to open that rule in Designer Studio.

3. In the Application Explorer, locate the property that you want to add to the section.

4. Drag the property into the section where you want it to display.

5. Click Save as.

6. Save the rule to the default Applies to class and make sure that the ruleset is for your application.


8. Click Save.

Adding a new section to the Interaction Portal

1. In the Interaction Portal, click Live UI and determine the section to which you want to add a section.


3. In the Application Explorer, locate the section that you want to add.

4. Drag the section into the section where you want it to appear.

5. Click Save as.



8. Click Save.

Additionally, with sections, you can use When rules to update which layouts and sections are visible. This is helpful if you want a manager to see content that a non-manager should not be allowed to see.

To modify the visibility of a display, follow these steps.


Delivery stage

1. Click the View properties icon to configure the layout or section.

2. Change the Visibility to Condition.

3. Enter a When rule or conditional expression.

4. Click OK.

5. Click Save.

Updating the Interaction Portal skin

You can update the look and feel of the Interaction Portal to reflect the color scheme of your company. Pega Customer Service for Healthcare takes advantage of the standard Pega Platform skinning features within an application.


2. Click ApplicationName > Definition.

3. Update the look and feel options as appropriate.

4. When you are finished, click Save as.

Note: To learn more about skins, click Help.


6. Click Save.

If you give your skin a different name, you need to update the application to reflect the new name.

1. In Designer Studio, click ApplicationName > Definition.

2. Change the Skin field to the skin that you created.

3. Click Save.

Configuring Interaction Portal tabs

When creating a Pega Customer Service for Healthcare application, you can add or modify the tabs located in the composite.


Delivery stage

The composite uses standard Pega Platform user interface elements. To create a new tab, create a section containing the information that you want to see. Once you create a section, add it to the composite.

1. In the Interaction Portal, click Live UI and determine the section used to display composites.


3. In the Application Explorer, locate the section that you want to add.

4. Drag the section into the section where you want it to appear.

5. Click Save as.



8. Click Save.

Launching a service case from the composite

It is easier and more efficient to launch a service case directly from the composite rather than using the Add Task menu. For example, you want to display an Edit link next to the customer's address to enable a CSR to change an address more quickly.

1. In the Interaction Portal, click Live UI and determine the section where you want to launch the service case.


3. Add a UI element, for example a button or link, into the section where you want to launch the service case.

4. Click the View properties icon to configure the UI element.

5. Click Actions.

6. Click Create an action set.

7. Click Add an event.

8. Click Click.


Delivery stage

9. Click Add an action.

10. Click All actions.

11. Click Create work.

12. Specify the Class Name and Flow Name of the service case that you want to launch.

13. Click OK.

14. Save your updated section.

Logging an event during an interaction

Customer Service Representatives (CSRs) convey information when interacting with customers. For example, a CSR can remind customers when their next payment is due. You do not want to create a process for this, but you do want to capture the information conveyed to the customers.

1. In the Interaction Portal, click Live UI and determine the section where you want to log information.

2. Add a UI element, for example, a check box, in the section where you want to log the conveyed information.

3. Click the Open property panel icon to configure the UI element.

4. In the Cell Properties dialog box, click Change to modify the control type used.

5. Click Other in the Advanced section.

6. In the Select a control text field enter CPMHistory.

7. Click Parameters tab and enter the field details.

l FieldName - Name of the Field Value property to use.

l FieldValue - Value of the Field Value property to use.

l DefaultImage - Image that should appear when not selected.

l ClickedImage - Image that should appear when a CSR clicks the default image.

l ReasonFieldValue - In the Wrap Up, this option appears in the Reason for interaction list.


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l TickedImage-The image that you want to display when the Express History check box is selected.

8. Click OK.

9. Save your changes.

Changing the home page reports

You can modify the reports shown on the home page. The reports shown can change, based on the role of the user logged into the Interaction Portal.

1. In the Interaction Portal, click Live UI and determine the reporting section in the Home page.


3. Configure this section by removing the charts that you do not want and adding charts to this section.

Note: For more information about working with charts, click Help.

4. Save your changes.

Configuring the portal searchWith the search functions of the Pega Customer Service for Healthcare portal, users can search for cases (work objects), knowledge content, and data sources such as accounts, contacts, and business units.

When the user selects a result from the list, Pega Customer Service for Healthcare opens a tab in the general work area to either display the work object (case) or the data source. When the account or contact is selected, a research interaction is created (.pyWorkIDPrefix = RI-), allowing the user to run service processes in a similar manner to a phone interaction. Because a research interaction is not an interaction with a customer, dialogs and coaching tips are not displayed. Other capabilities such as Pega Knowledge, and Other Actions are available to the user.

Complete the following tasks to configure portal search.

• Configuring the portal search for external data sources

• Configuring search for cases and work objects


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Configuring the portal search for external data sources

Pega Customer Service for Healthcare uses Data Source rules to configure portal search functions for external data sources. For any external data source that you want to include in the Pega Customer Service for Healthcare portal search, use the following steps to configure the data source.


2. Click Designer Studio > Customer Service > Customer Data Management > Customer Service Data Sources. The Customer Service Data Sources page is displayed.

3. Select All Inherited in the Show data sources in field and click Run. The list of available data sources is displayed.

4. Select your data source from the list.

5. On the Search tab of your data source rule, select the Use in Portal Search? check box and select the name of the integration activity to call to perform the search query.

6. On the Retrieval tab, complete the following fields defining the retrieval criteria.

Default Interaction Driver

Enter the name of your site-specific class that inherits from the PegaCPMHC-Work-Interaction-Research class. This class is used to create a temporary work object to display data source results.

Display Harness

Enter the name of the harness in the default interaction container class used to display data source information once the user selects a result of this type from the portal search results list.

Retrieval Activity

Enter the name of the integration activity (in the default interaction container class) that used to retrieve any additional information needed to populate the display harness view.

Configuring search for cases and work objects

Pega Customer Service for Healthcare uses the Pega Platform search facility for work objects and case data. Pega Customer Service for Healthcare searches for your work types/objects only if they are listed on your application rule or an inherited application rule.

When a user selects a work object or case from the portal search results list, a tab is opened in the general work area using the Review harness for that work type.


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For more information on enabling search of work data for your application, see the Pega Platform help.

Quality reviews and customer satisfaction surveysYou can configure the content and scoring rules used to implement quality management reviews and customer satisfaction surveys.

Complete the following tasks to configure reviews and surveys.

• Configuring survey rules

• Configuring survey rating categories

• Configuring survey selection

• Determining interactions to survey for customer satisfaction

• Changing Net Promoter settings

Configuring survey rules

Pega Customer Service for Healthcare uses survey rules for both quality management and customer satisfaction survey processing.

Survey rules determine the scoring criteria and the questions asked in the survey.


2. Enter SampleQualitySurvey, in the Search field of the Designer Studio landing page.

3. Click Save as, select the Applies To class, and enter the name of the survey as the Purpose. Save it to your ruleset.

4. Enter a short description for the survey. This value becomes the name of the survey.

5. On the Scoring Levels tab, enter a title name for each scoring level. The titles appear when a user is responding to the survey.

6. On the Questions tab, enter information in the fields described below. All fields are required.


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l Category - Enter the name of the category to be evaluated.

l Question - Enter the text question that is to be displayed to the person responding to the survey.

l Weight - Enter the integer or decimal value that is used as a weighting factor when calculating the survey score for this category.

l Level 1-5 scores - Enter the numeric score for each level that can be selected for the category.

7. Click Save.

Configuring survey rating categories

You can set rating categories for reviews and surveys that are based on the total survey score calculated by the system.

Example: A score of less than 2 results in an overall rating of Needs Improvement while a score greater than 4 results in an overall rating of Exceeds Expectations.


2. From the App Explorer, select PegaCA-Work > Decision > Map Value > CAGetOverallRating.

3. Click Save as, enter a map name, and save it to your ruleset.

4. On the Matrix tab, update the table to include the following items.

l Total Score — enter the evaluation criteria as (for example, < or <) and total score.

l Overall Rating — enter the text that you want to associate with the score.

l Default — enter the default text; surround the text by quotes.

5. Click Save.

Configuring survey selection

With Pega Customer Service for Healthcare, you can differentiate surveys first by work type (the class name that the survey applies to) and then by decision rules that specify custom criteria.


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Example: You want your high-value customers to receive different satisfaction surveys from those received by standard customers. Entry-level CSRs and experienced CSRs could be evaluated using two different surveys.


2. From the App Explorer, select PegaCA-Work > Decision > Decision Tree.

3. Select one of the following instances and save it to your ruleset.

l CADetermineQualitySurvey — sample quality review survey

l CADetermineSatisfactionSurvey — sample customer satisfaction survey

4. On the Decision tab, enter the decision criteria and the name of the survey that you want to display.

5. Click Save.

Determining interactions to survey for customer satisfaction

You can configure the criteria used to determine which customer interactions initiate customer satisfaction surveys.


2. Enter SatisfactionSurvey, in the Search field of the Designer Studio landing page.

3. Select the Intent Task instance and save it to your ruleset.

4. On the Criteria tab, add the Intent When rule Select as the Intent Condition.

5. Indicate whether you want to suggest the process or queue the process when the condition evaluates as true.

6. Enter the visual cue that you want to associate with the condition from the image catalog that is displayed when you click the Lookup icon

7. Click Save.

Changing Net Promoter settings

The NPS survey embedded section (NPSRatingInWrapUp) in wrap-up has been configured to not display using a Visibility Condition. To enable display of the NPS section during interaction wrap-up,


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remove the Visibility condition in the appropriate interaction class for the relevant section (example: PegaCA-Work-Interaction.CAWrapUpCommon).

The following section assumes that the Visibility condition (referenced above) has been removed.

During interaction wrap-up, Pega Customer Service for Healthcare will calculate a Net Promoter scores based on the response to this question.

On a scale of 0-10, how likely are you to recommend us to a friend?

The Net Promoter Score question UI is contained in the section PegaCA-Work.NPSRatingInWrapUp. To remove the NPS question from your wrap-up process, copy the CAWrapUp section for your interaction class into your site-specific ruleset and delete the embedded section for NPSRatingInWrapUp.

In Pega Customer Service for Healthcare, the question detail is stored on the interaction object itself upon clicking Submit. Pega Customer Service for Healthcare will calculate the response and quantify the interaction as one of the following.

l Detractor (0-6)

l Passive (7-8)

l Promoter (9-10)

This detail can be used in future interactions to set the Interaction Goal property and to drive specific application behaviors when configured.

Pega also offers a Net Promoter Framework. If installed, answering the Net Promoter question in wrap-up also creates a Net Promoter object. When the response is Detractor or Passive, a follow-up case is created.

More details on the Net Promoter Framework can be found in the Technical Note - Using the Net Promoter Framework.

Customer Decision HubThe Customer Decision Hub provides the suggested actions to the customer service representative (CSR) during a customer interaction with the help of Pega Customer Service for Healthcare and Pega Customer Decision Hub.

Note: To use Customer Decision Hub features, install the Pega Customer Decision Hub application. Those applications require a separate license. For information about how to install Pega Customer Decision Hub , contact your Pega support representative.


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Configuring Customer Decision Hub

Before configuring Customer Decision Hub, ensure that the Pega Customer Decision Hub application is installed. For installation information, contact your Pega support representative.

The Customer Decision Hub configuration page enables the communication with the Pega Customer Decision Hub application to provide next best actions.

1. Log in to Designer Studio, and then click Designer Studio > Customer Service > Customer Experience > Customer Decision Hub configuration.

The Customer Decision Hub configuration page opens.

2. Click the NBA Enabled link and update the .NBAAdapterSetting target value to "true" to enable the communication with decision hub.

Save the rule into your implementation layer. For additional information about locked and unlocked rulesets, see Copying a rule or data instance.

3. On the Customer Decision Hub configuration page, click the Customer Decision Hub Server link and add the Pega Customer Decision Hub URL, for example, http://<localhost>:<port>. Click Save to save the data instance.

4. Optional: On the Customer Decision Hub configuration page, click the Map Additional Interaction Context link to update or add context information for strategies to process and respond with appropriate actions. Then, update the data transform rule.


Note: Pega Customer Decision Hub follows a defined structure to map the context properties. Follow the examples from the data transform rule. Be cautious while adding or updating Type, Key and Value properties in the data transform rule.

5. On the Customer Decision Hub configuration page, click the Update Containers link and update the mapvalue rule, to update the container name.


6. On the Customer Decision Hub configuration page, click the Update button in the center of the page to update the list of configured actions, such as TopOffers, RetentionPeak,


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NeedsAssessment, and LostStolenCard. Each action is mapped to a call, a flow rule, a Boolean property to display or hide peak offers, and an image.


Configuring access groupsA new application includes Pega-provided access groups and access roles that you can view in Pega Express by clicking Users panel > Roles.

It is a best practice to create new access groups and roles that are based on the default access groups and roles that come with the product. This insulates your application from changes if the roles and groups change permissions in a future release. Refer to the roles and groups that you identified in the Defining your authorization scheme section.


To associate an access group with a role, follow these steps.


2. Click Users panel > Roles. The list of all access groups and access roles provided by the application is displayed.

3. Click Add role and enter the details. This adds an access group to a particular role.

4. Click Done. For more information, see Access Group data instances.

To update an access group, follow these steps.


2. Click Users panel > Roles. The list of all access groups and access roles provided by the application is displayed.

3. Select the access group that you want to modify and update the details. You can only change the portal details for the access group.

4. Click Done. For more information, see Access Group data instances.

To update an access role, follow these steps.

You can update or add a new access role details only from Designer Studio.


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2. Click Designer Studio > Org & Security > Groups & Roles > Access Roles.

3. Select the access role that you want to use, for example PegaCA:Manager.

4. Click Save as to save the role to your application. It is recommended to give the role a different name.


6. Update the new role details.

7. Click Save.

Configuring reportsPega Customer Service for Healthcare includes many standard reports for monitoring and analyzing work. For detailed information about each report, see Pega Customer Service for Healthcare reports on the Pega Customer Service for Healthcare product page.

For information about creating reports, see Creating reports in Case Manager.

Configuring the Estimated Application Savings report

The Estimated Application Savings report calculates the savings achieved using Pega Customer Service for Healthcare by comparing the call duration for a service process against an average benchmark for the same process run in a legacy system. The time savings are then multiplied by a cost factor to apply a dollar value to the savings achieved.

Setting up the report

Record the following information.

l An interaction cost per second value

l A benchmark duration value for each process that you want to calculate

l The SavingsAmount and TimeSavings Declare Expression rules

l Optional updates to the savings report


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Configuring the report 1. Identify the relevant service case class that you want to add to the Estimated Application Savings

report.

2. Copy an instance of .CAProcessTimeCost to your ruleset, and then apply it to the relevant service case class.

3. On the Expressions tab, update the cost value of CAProcessTimeCost as cost per second.

4. Click Save.

5. Copy an instance of .CABenchmarkDuration to your ruleset, and then apply it to the relevant service case class.

6. On the Expressions tab, update the value of the duration in seconds.

7. Click Save.

8. Copy an instance of .SavingsAmount to your ruleset, and then apply it to the relevant service case class.

9. On the Change Tracking tab, change Execute this expression to regardless of any pages it is contained in.

10. Click Save.

11. Copy an instance of .TimeSavings to your ruleset, and then apply it to the relevant service case class.

12. On the Change Tracking tab, change Execute this expression to regardless of any pages it is contained in.

13. Click Save.

Repeat these steps for each service case class that you want to include in the calculation. Samples are provided for the following classes under the PegaCA-Work class.

l AddressChange

l CloseAccount

l Complaint

l Correspondence


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l DisputeTransaction

l General

l Interaction

l Interaction-InCorr

Modifying the Savings report


2. From the Application Explorer, select PegaCA-Work > Reports > Report Definition > CPMApplicationSavings.

3. Edit the report to meet your requirements.

4. Click Save.

Modifying the Drill-down report

1. Open the User Interactions tab for the CPMApplicationSavings report definition.

2. Copy an instance of the drill-down report to your ruleset.

3. Modify the drill-down report.

4. Update the CPMApplicationSavings report definition to point to the modified drill-down report.

Testing a new applicationTesting a new application includes the following procedures:

• Testing your application in the Build environment

• Testing in the Test or Production environments

• Testing in the UAT environment

Testing your application in the Build environmentTest a new application in the Build environment before migrating the new application to a Test or Production environment. Testing in the Build environment enables you to verify that basic


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functionality and interfaces work correctly and also that performance is acceptable.

1. Run functional tests to test specific features from the end-user perspective.

2. Test features used by all service intents, such as: security, eligibility, search, and loading of data. For this unit testing, automated scripts are recommended but not required.

3. Use the Performance tool to measure the performance of the application. For information about the Performance tool, see About the Performance tool.

l Prior to extending your site-specific Pega implementation, establish a performance benchmark (baseline) using the Performance tool. This allows subsequent, iterative performance tests against the established baseline to help identify any degradation in performance resulting from development efforts.

l Use the Performance tool to check the performance of the following features:

Search

Account selection

Loading of components

Kickoff of all service intents. For this unit testing, automated scripts are recommended but not required.

l Save the test results so that you can compare them to future test results to determine whether an application update has a performance impact.

4. Verify that the Pega-provided reports and your custom reports run successfully, and that they show your implementation layer data, rather than the default demonstration data. This can be an automated test.

5. Test all integrations, both independently and with associated integrations.

Test integrations for any optional Pega Customer Service for Healthcare components and other applications that you plan to use. See the product documentation for the component or application to determine which product components to test.

For Pega Call, check the following pieces of moving infrastructure:

l Switch

l Provider software


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l Connectivity (network)

l CTI engine

l Integration to the CTI engine

In addition, check all delegated rules (for example, coaching tips).

6. Test security. Test the most common roles to ensure that the required access groups are configured and point to the correct software version.

Testing in the Test or Production environmentsAfter you import the application to a Test or Production environment, test the application in the new environment to verify that it works correctly in that environment.

Notes: For a multitenancy configuration, run tests in each tenant region.

The testing performed in the Test environment should include usability testing to ensure that the application meets the UI standard.

1. Verify that the source and the destination files are the same.

2. Run functional tests to test specific features from the end-user perspective.

3. Test features used by all service requests, such as security, eligibility, search, and loading of data. For this unit testing, automated scripts are recommended but not required.

4. In the Test or Production environment, run the Application Guardrails Compliance Score to ensure that the application meets guardrails.

5. Verify that there is an open Production ruleset so that managers will be able to edit dialogs, coaching tips, and knowledge content in the Test and Production environments, and so that they can share those changes. Rulesets are typically locked during migration; you will need to unlock the ruleset after migration.

6. Verify that the Pega-provided reports and your custom reports run successfully, and that they show your implementation layer data, rather than the default demonstration data. This can be an automated test.

7. Test all integrations, both independently and with associated integrations.


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Test integrations for any optional Pega Customer Service for Healthcare components and other applications that you plan to use. See the product documentation for the component or application to determine which product components to test.

For Pega Call, check the following pieces of moving infrastructure.

l Switch

l Provider software

l Connectivity (network)

l CTI engine

l Integration to the CTI engine

In addition, check all delegated rules (for example, coaching tips).

8. Verify that the integrations point to the correct system of record, and not to the system of record for the Build environment.

9. Test security. Test the most common roles to ensure that the required access groups are configured and point to the correct software version. Use these common roles in your smoke tests (see next step).

10. Run a smoke test to compare the source and destination environments. Verify that all tests that pass in the Build environment also pass in the Test or Production environment. If anything fails, compare the environments to determine whether a difference in environment could cause the test to fail. If the environment caused the failure, either fix the issue that caused the failure or adjust the test as appropriate for the new environment.

11. Run performance tests to verify that performance meets expectations. Pega recommends automated performance testing. Save the results so that you can compare them to future performance test results to determine whether an application update has a performance impact.

Testing in the UAT environment After you complete testing in a Test environment, it is common for large call centers to perform User Acceptance Testing (UAT) in a designated UAT environment, which could be a pre-production environment. UAT ensures that end users will be able to successfully complete work and meet business objectives.


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Note: Organizations that use Scrum for application development will complete less formal UAT as part of each sprint cycle.

1. Verify the integrity of the UAT environment.

2. Have the end-users (or business analysts acting the role of end-users) run scripts to test all scenarios including boundary and exception testing. The end-users (that is, the trainers, managers, and directors), perform the following steps during UAT:

l Verify that there are no major issues.

l Review changes in order to better understand the features.

l Customize the delegated rules (for example, coaching tips) as needed.

Packaging a new applicationTo migrate a new application to a different environment, you must first package the application so that it can be imported to the new environment.

Packaging and importing a new application includes the following procedures:

• Merging application changes

• Packaging an application for migration

• Importing the packaged application

• Multitenancy deployment considerations

• Overriding rules to use Pega Social

If deployment is to a Multitenancy environment, see Multitenancy deployment considerations.

Merging application changesIf you developed your application features in separate branches, use the Merge Branches wizard to merge the branches before you package the application. The wizard shows any merge conflicts so that you can correct them before you merge the branches.

For more information about using Merge Branches wizard, see Branch development.


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Packaging an application for migrationBefore you can migrate a new application to a different environment, you must package the relevant data instances and rulesets into a product rule. The product rule is an instance of Rule-Admin-Product, and it is referred to as the RAP file.

1. Click Designer Studio > Application > Distribution > Package to start the Application Packaging wizard. For information about using the wizard, see Application Packaging wizard.

2. Complete each page of the Application Packaging wizard.

3. On the last page of the wizard, click Preview.

4. Review the contents of the generated RAP file.

5. On the last page of the wizard, click Modify to make any changes.

6. When the RAP file is complete, click Export. The wizard creates a .ZIP file in the ServiceExport directory on the current application server node.

Importing the packaged applicationTo deploy a new application to a different environment, import the .ZIP file that contains the packaged application to the new environment.

1. Click Designer Studio > Application > Distribution > Import.

2. Use the Import Gadget to import the target .ZIP file. For more information, see Import wizard landing page.

For information about how to swap the database connection pointers to your Production database after an import to a Production environment, see Pega Platform Upgrade Guide.

Note: For an on-premises Pega Co-Browse integration, be sure to update the data transform rule to point to the correct Pega Co-Browse server if necessary.

Multitenancy deployment considerationsIn a multitenancy environment, the shared application components are deployed only to the shared environment, and the tenant-specific components are deployed only to the tenant region.


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For information about how to package and deploy a shared application or a tenant-specific application, see the Multitenancy Administration Guide.

A deployment to a multitenancy environment has the following requirements.

l The package for the tenant layer should include production rule sets for that tenant. The package for the shared layer should not include production rule sets.

l The package for the tenant layer should include the tenant-specific Pega Call configuration settings, such as sample operators, service packages, CTI links, and call objects. The package for the shared layer should include the global Pega Call configuration settings that apply to all tenants, such as Pega Call rules.

l The package for the tenant layer should include the table definitions for that tenant.

Note: Multitenancy is not supported for Pega Social.

Overriding rules to use Pega SocialTo configure Pega Social, override the following rules in the implementation layer class where interaction work instances are created.

Feature RulesProfile Data page -D_Contact_Details

Widget - Agent performance Report definition - TeamPerformance

Widget - Team performance Report definition - TeamPerformanceForWorkgroup

After you override the rule, complete the following steps for widgets - Agent performance and Team performance.


2. In the search field, enter TeamPerformance.

3. Open the report definition - TeamPerformance.

4. On the Data Access tab, in the Class joins section, enter your class in the Class name

5. On the Pages & Classes tab, in the Class field, enter your class.


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Production maintenance and monitoringProduction maintenance and monitoring includes the following procedures:

• Business rule maintenance in the Production environment

• Application health monitoring

• Identifying and reporting issues

Business rule maintenance in the Production environmentAs a manager, you can update Dialogs, and Coaching Tips in the Production environment using the Tools > Configuration option available in each process action of the case type. This feature allows managers to change these options without having to wait for a rule deployment. Managers must have the same privileges associated with the PegaCA:Manager role in order to maintain these rules.

Note: Skills instances need to be created in order for them to be available in the selection of available Expert Skills.

Managers can also create reports in the My Reports section of the portal. For more information, see Report Browser features.

You can give managers the ability to update other rule types in the Production environment. For example, managers can update the Goals and Deadline for a certain case type. These rules must be delegated in Designer Studio first. After the rule has been delegated, you can access it in the Interaction Portal by clicking Profile menu > My rules. For more information on rule delegation, see Delegating a rule or data type.

Application health monitoringPega Autonomic Event Services is an application that automatically monitors, retrieves, and organizes the alert data from one or more clustered systems throughout the enterprise. Pega also


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provides the Pega Predictive Diagnostic Cloud, which allows you to benefit from Pega Autonomic Event Services without installing it locally. Pega Predictive Diagnostic Cloud is a Software as a Service offering of Pega Autonomic Event Services.

Implementing the following best practices in your application can help to ensure optimal response times and overall application health:

l Segment application agent processing to a dedicated JVM (Java Virtual Machine). This configuration ensures that end users do not have to share resources with background processes.

l Monitor integration response time. Over time, slow integration points can cause average handle times to increase. When queues start to grow, it becomes very difficult to recover, which might require usage of offline services or a backup application.

l Regularly perform a Layer 7 health check. Layer 7 is the application layer of the OSI model. Having visibility into the details of a connection can allow you to filter out unwanted traffic from entering your call center, such as for example, in the form of a DDoS attack. It can also help with load balancing. Having visibility into call details also provides information that is needed to more intelligently route the call.

l Regularly perform a health check on the CTI layer. Periodically check to ensure that the application can communicate with the switch. Periodically call the application to make sure it can get through an entire process.

l Monitor social accounts (for example, your Facebook and Twitter accounts) to ensure that they do not expire. For more information, see Pega Social Implementation.

Identifying and reporting issuesAs with any application, your users will encounter issues that they need to report as they begin to use the application. When deploying your application to the production environment, complete the following steps:

1. Identify operational staff who will be responsible for responding to issues reported in the production environment.

2. Establish procedures with those resources to triage, respond to, and escalate issues.

3. Determine procedures for delivery of changes to the production environment.


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Pega Chat implementationCustomers can implement Pega Chat at the same time as Pega Customer Service for Healthcare, or they can add this component later. For more information about Pega Chat, see the Pega Chat product page.

Pega Chat implementation includes the following processes.

• Defining requirements for Pega Chat implementation

• Building Pega Chat features

• Testing, packaging, and maintaining Pega Chat

Note: Pega Chat includes features that use the Text Analytics/Natural Language Processing features of the Pega Platform. If you have licensed Pega Chat, you can use Text Analytics/Natural Language Processing features solely with Pega Chat unless you have licensed these features separately for other purposes. Contact your Pega Account Executive if you require a license to use the Text Analytics/Natural Language Processing features for other purposes.

Defining requirements for Pega Chat implementation

1. Defining which web pages will have chat capabilities

2. Defining the chat window branding

3. Defining optional proactive chat

4. Defining the chat queues and operator skills

5. Defining URL mappings for chat

6. Defining common phrases

7. Defining web pages to push for chat

8. Defining optional Pega Co-Browse settings


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9. Defining dashboard widgets

10. Defining the chat server location and communication settings

Defining which web pages will have chat capabilities To list the pages on your website that will have chat capabilities, use the "Chat-enabled web pages" worksheet in the Implementation Planning Workbook.

Defining the chat window brandingYou can customize the chat window to better match your website or branding.

The header section of the chat window is the logo and message that appears at the top of the window.

The text section of the chat window is the conversation area, which includes system messages.

To record your decisions during this procedure, use the “Customer chat experience” worksheet in the Implementation Planning Workbook.

1. Determine the font family, font color, and background color for the text, the chat header text, and the message header oval sections.

2. Determine which image to display to the left of the chat header text. For example, you can display a company logo. The header can fit a 21 pixel by 21 pixel image.

Defining optional proactive chatFor web pages that are enabled for chat, you can optionally configure Pega Chat to invite the customer to a chat session, rather than waiting for the customer to request assistance.

To record your decisions during this procedure, use the “Proactive chat” worksheet in the Implementation Planning Workbook.

1. Determine whether to enable proactive chat.

2. To enable proactive chat, define the criteria that determines when the customer will be invited to a proactive chat session. The criteria can include one or more of the following metrics.



l How long (in seconds) that a customer views a chat-enabled web page.

l How long (in seconds) that a customer views a website that has at least one chat-enabled web page. The customer will be invited to proactive chat only when they have a chat-enabled web page open.

l The number of chat-enabled pages that a customer views.

3. Determine the message to display to a customer to invite them to the proactive chat session.

Defining the chat queues and operator skillsA chat queue is the work queue for chat requests that are received from one or more chat-enabled web pages. The chat server routes a chat request to a CSR based on whether the CSR has the required skills for that queue, and whether the request is received during working hours for that queue.

For a chat window, you can configure a chat queue to send pre-chat questions to a customer in order to gather information before the chat request is routed to a CSR. For example, the chat server can request a customer’s name, account number, and the question that they have.

The answer can be used for subsequent interaction processing.

Note: If the answer to a pre-chat question is known before the chat session starts, you can pre-populate the answer when you enable chat for a web page. In that case, the chat server will not ask the pre-chat question. An answer can also be pre-populated automatically by your website based on user login credentials or other information. For information about how to pre-populate an answer, see Enabling chat on your website.

To record your decisions during this procedure, use the “Chat queues” worksheet in the Implementation Planning Workbook.

1. Identify the different types of chat requests that you expect to receive and the skills required to service each request.

2. Determine how many different chat queues you need to route chat requests to operators with the required skills.

3. Determine a name for each chat queue.

4. Identify the hours of operation for each chat queue.

5. Determine what message to display when a customer requests a chat session outside of business hours for the chat queue.



6. Determine what message to display when a customer requests chat when there are no agents available or no agents available with the required skills.

7. Determine the service level goals for each chat queue. Identify the percentage of chat customers that your CSRs should be able to respond to, and the number of seconds within which they should respond.

8. Determine which pre-chat questions you want to ask for each chat queue.

9. Define a property name (also known as a key) for each pre-chat answer. During a chat interaction, a CSR can access the property and other metadata related to this chat request from their Pega clipboard.

The metadata are available in the form of key-value pairs in a value group ChannelServicesInteraction.pyUserData on the interaction page. Answers to pre-chat questions are accessed from pyUserData using the key specified. The answers can be displayed on the CSR desktop, and they can be used to trigger, modify, or suggest service processes.

The Configuring channels topic describes tasks that can include Pega Chat metadata.

10. Determine whether and when to pre-populate pre-chat answers. For example, certain values might be pre-populated based on the user's profile on your website.

11. Identify which CSR operators have the required Pega Chat skills to respond to the chat queue. For information about defining operator skills, see Defining the operator attributes.

Note: Only the following characters are allowed in the operator ID of a Pega Chat CSR: alphanumeric characters, @, &, ', and <space>. The operator ID cannot contain any other special characters, nor can it contain more than one @ symbol.

For more information on how to configure, see Configuring chat queues for Pega Chat.

Defining URL mappings for chatFor web pages that are enabled for chat, you can assign a chat queue to one or more web pages based on the URL pattern of the web pages. For example, you can assign all web pages that include the term "-sales" in their URL to a specific queue. This enables you to quickly assign or modify the chat queue for multiple pages.

Note: The JavaScript snippet that enables chat for a web page includes parameters that determine whether the page uses URL mappings to assign a chat queue.



To record your decisions during this procedure, use the “URL mapping for chat” worksheet in the Implementation Planning Workbook.

1. Identify each URL pattern.

Note: Use the * wild card pattern to define a default chat queue for web pages that do not match any other pattern.

2. Identify the chat queue for each pattern.

Defining common phrasesPega Chat lets CSRs insert frequently used phrases in the chat window by selecting them from the Phrases menu during a chat session.

To record your decisions during this procedure, use the “Common phrases” worksheet in the Implementation Planning Workbook.

1. Define the categories of common phrases that will be seen by the CSR. During a chat session, each category is presented to the CSR as a separate submenu from which they can select a phrase.

2. Define a short name for each phrase that will clearly identify the phrase to the CSR.

3. Define the complete text that a customer sees in the chat window when a CSR selects the phrase. If the phrase includes text that is formatted as a link (for example, the text starts with "http://"), then the chat window converts the text to a link when a CSR sends the phrase.

4. To restrict selection of this phrase to customers with specific browser locales, identify the language of the phrase. By default, a phrase applies to all languages and locales.

For more information of configuring common phrases, see Configuring common phrases.

Defining optional Pega Co-Browse settingsIf you want to enable Pega Co-Browse capabilities from a chat window, obtain the Pega Co-Browse API key that is needed to start the co-browsing session.

For more information about how to obtain that key, see the Pega Co-Browse Implementation Guide on the Pega Customer Service product page.




To record the Pega Co-Browse API key, use the “Chat-enabled web pages” worksheet in the Implementation Planning Workbook.

Defining dashboard widgetsChat widgets display historical or real-time chat statistics on the Interaction Portal dashboard.

To record your decisions during this procedure, use the “Chat widgets” worksheet in the Implementation Planning Workbook.

1. Log in to Designer Studio using the administrator operator ID for your application.


3. Click Dashboard.

4. Click the Switch to edit mode tool .

5. Under Widgets, click Add Widget(s).

6. On the Widgets window, scroll to the CHAT section, and decide which chat widgets you want to show on your dashboard.

For detailed information about how to add widgets to the dashboard, see Designing the portals.

Defining the chat server location and communication settingsThere are two options for the chat server installation. Pega can install it for you as part of the Pega Cloud Collaboration Services, or you can install it yourself on premises. Once the chat server is installed, you must configure how Pega Customer Service for Healthcare connects to that chat server.

To record your decisions during this procedure, use the “Chat server” worksheet in the Implementation Planning Workbook.

1. Determine whether the chat server will be installed in the cloud using Pega Cloud Collaboration Services or on-premises.



Notes: For information about installing a chat server on-premises, see the On-Premises Chat Server Installation article on the Pega Chat product page.

If you use Pega Cloud Collaboration Services, you must configure your application to use the AllowPegaCollaborationServices security policy. For more information, see Configuring the content security policy.

2. Determine the following communication information for the chat server.

l The host name, IP address, or domain name of the installed chat server or chat infrastructure. For an on-premises server, this value is likely to be a domain name that resolves to a load balancer. For Pega Cloud Collaboration Services, this is usually chat.usefirefly.com.

l The protocol (http or https) used to configure chat. Pega Customer Service for Healthcare server will connect to the chat server using this protocol.

l The TCP port used to configure the chat server. Pega Customer Service for Healthcare server will connect to the chat server on this port.

l The unique configuration key used to configure the specific chat server.

If you use Pega Cloud Collaboration Services, you will receive this information in an email sent to the provisioning email address that you provided. If you install the chat server on-premises, request this information from the person who installed the chat server.

Note: A chat server is identified by its configuration key. A chat server (and configuration key) must be associated with only one Pega Platform environment. You should create only one chat server record on the Pega Platform to represent each chat server. If you select the same configuration key in more than one record or environment, then each subsequent record or environment will attempt to delete configuration elements (for example, queues and operators) created by the other configuration or environment.

3. Determine the following client communication information.

l The protocol (http or https) used by the CSR and customer web browsers to communicate with the chat server.

l The TCP port used by the customer and CSR web browsers to communicate with the chat server.




l The frequency (in seconds) to reconnect the customer and CSR web browsers to the chat server, in the event or a network interruption or chat server restart.

l The maximum number of reconnection attempts.

l The maximum number of chat conversations that a CSR can engage in at the same time.

4. The protocol (http or https) used by the CSR and customer web browsers to communicate with the chat server.

5. The TCP port used by the customer and CSR browsers to communicate with the chat server.

6. The frequency (in seconds) to reconnect to the chat server.

7. The maximum number of reconnection attempts.

8. The maximum number of chat conversations that a CSR can engage in at the same time.



Building Pega Chat features• Configuring the content security policy

• Configuring the chat server communication settings

• Configuring pre-chat questions for chat

• Branding the customer chat window

• Configuring optional proactive chat

• Configuring URL mappings for chat

• Enabling chat on your website

• Configuring co-browse in Pega Chat

• Enabling automatic Pega Chat login

Configuring the content security policyNote: Complete this task only if you have hosted Pega Chat on cloud. On-premises clients must take care of security of their own installation.

A content security policy is a type of security provided through the HTTP response header. It specifies the uniform resource locators from where web page resources such as frames, images, and stylesheets are loaded. It helps to prevent common web vulnerabilities such as code injection and cross-site scripting. If you do not define this policy then the browser loads page resources that might have malicious content. For more information about content security policy, see Content Security Policies.

If your Pega Chat implementation uses the Pega cloud collaboration services, update your Pega application to use the AllowPegaCollaborationServices content security policy. For more information on Pega cloud collaboration services, see Pega Cloud Collaboration Services.

1. Log in to Designer Studio by entering your administrator credentials.

2. Click the Application menu > Definition.

3. On the Integrity & security tab, in the Policy name list, select

AllowPegaCollaborationServices.

4. Click Save.



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Configuring the chat server communication settings Configure the chat server settings to communicate with the Pega Customer Service for Healthcare application. To configure the settings, identify the details such as host name, IP address, and port as mentioned in the Defining the chat server location and communication settings

1. Click Designer Studio > Channel Services > Pega Chat > Administration & Configuration.

2. To add a new chat server, click Add new.

3. On the Create Chat Server Configuration page, complete the required fields and click Create and open.

4. In the Server Configuration section, perform the following steps:

a. In the Chat server type list, select a server type.

b. In the Chat server hostname field, enter the host name or IP address of the chat server, or the domain name of the chat infrastructure.

Note: Do not enter http or https, enter only the host name, such as example.com

c. In the Configuration protocol list, select a protocol.

d. In the port field, enter the port number.

e. In the Server configuration key field, enter the server configuration key so that the chat server can communicate with Pega Customer Service.

f. In the Asset host URL field, enter the URL for this chat server.

Note: Do not create more than one chat server configuration using the same configuration key.

5. In the Client Communication section, perform the following steps:

a. In the Communications protocol list, select a protocol.

b. In the Port field, enter the port number for communication between the customer and customer service representative web browsers and the chat server.



c. In the Reconnect interval (Sec) field, enter the frequency in seconds that the customer and customer service representative web browsers should reconnect with the chat server if the connection is lost.

d. In the Reconnect attempts field, enter the maximum number of times to reconnect the customer and customer service representative web browsers with the chat server.

e. In the Max concurrent conversations field, enter the maximum number of simultaneous conversations allowed for a customer service representative.

f. In the Chat transcript update interval field, enter the frequency in seconds to update the chat transcripts.

6. To calculate the average time that a chat server takes to handle the number of chats, in the Average handle time evaluation window field, enter the time in minutes, for example, 60. This value is the minimum amount of time before the average wait time is calculated.

7. To calculate the average wait time that a customer has to wait before interacting with a customer service representative, in the Minimum number of chats for average wait time calculation field, enter the minimum number of chats, for example, 15. This value is the minimum sample size before the average wait time is calculated.

8. Click Save.

9. To modify an existing chat server, on the Administration and Configuration page, select the

chat server that you want to modify, click on the gear icon, and then click Edit.

10. Follow the instructions provided in steps 4 to 8.

Configuring pre-chat questions for chat 1. Click Designer Studio > Channel Services > Pega Chat > Administration &

Configuration.

2. Select the chat server, click the Options icon , and then click Edit.

3. Click the Queues tab.

4. Select the queue for which you will configure pre-chat questions, and then click the Edit icon .

5. In the Pre-chat questions section, click Add new to add a pre-chat question for this queue.



6. In the Key field, enter the name of the property to create for the answer to this question.

7. In the Question field, enter the pre-chat question that will be presented to a customer.

Note: For information about how to pre-populate a pre-chat answer for your website, see Enabling chat on your website.

8. Repeat these steps for additional pre-chat questions.

9. Click Submit.

10. Repeat these steps for each additional chat queue.

11. Click Save.

Branding the customer chat window 1. Click Designer Studio > Channel Services > Pega Chat > Administration &

Configuration.


3. Click the Customer Chat Client tab.

4. To configure the chat header settings, in the Chat Header section, perform the following steps:

a. Complete the font family, the header font color, and the header background color fields.

b. In the URL for chat icon field, enter the URL of an image file (21 pixels in height and width) to show at the left side of the header section.

5. To configure the chat text settings, complete the fields in the Chat Text section.

6. To configure the message header settings, complete the fields in the Message Header Oval section.

7. Click Save.

Configuring optional proactive chat 1. Click Designer Studio > Channel Services > Pega Chat > Administration &

Configuration.




3. Click the Proactive Chat tab.

4. To enable proactive chat, select the Enable Proactive Chat check box.

5. If you enable proactive chat, select one or more of the following check boxes to determine when a customer will be invited to a proactive chat session. You must select at least one check box.

a. To start a proactive chat session based on how long a customer views a chat-enabled web page, select the Offer chat when user stays on a page for NN seconds check box, and then enter the number of seconds.

b. To start a proactive chat session based on how many chat-enabled pages the user views, select the Offer chat when user views NN pages check box, and then enter the number of pages.

c. To start a proactive chat session from a chat-enabled web page based on how long a customer views your website, select the Offer chat when user stays on the website for NN seconds check box, and then enter the number of seconds.

6. In the Invitation text field, enter the message to display to the customer to invite them to a chat session.

7. Click Save.

Configuring URL mappings for chat 1. Click Designer Studio > Channel Services > Pega Chat > Administration &

Configuration.


3. Click the URL Mapping tab.

4. Click Add Item.

5. In the URL Pattern field, enter the pattern of the chat-enabled web pages that you want to map to a chat queue.



You can enter multiple values separated by the or operator, and you can include the * wildcard character. For example:

yoursite.com/*-sales or yoursite.com/newcustomer

6. From the Queue list, select the chat queue to assign to web pages that match the pattern.

7. Click Save.

Enabling chat on your website 1. From your code editor, open the layout file that will propagate to all of your site's web pages that

require chat capabilities.

2. Insert a JavaScript snippet similar to the one shown below in the web page code.

Note: A sample snippet is emailed to the administrator provisioning email address that you provided when the chat server was installed.

<script type="text/javascript">(function() {window.fireflyAPI = window.fireflyAPI || {};window.fireflyAPI._log = window.fireflyAPI._log || function(){};window.fireflyChatAPI = {};fireflyChatAPI.token=<your Chat API token>;fireflyChatAPI.cobrowseAPIKey=<your portal co-browsing API key>;fireflyChatAPI.queue = <your queue>;fireflyChatAPI.skipQueueSelection = <true or false>;fireflyChatAPI.assetHostUrl="https://firefly-chatproduction. s3.amazonaws.com";fireflyChatAPI.type = 'visitor';fireflyChatAPI.serverHostUrl = <yourchatserverUrl>;var script = document.createElement("script");script.type = "text/javascript";script.src = <yourchatserverUrl> + "/scripts/loaders/chatLoader.js";script.async = true;var firstScript = document.getElementsByTagName("script")[0];firstScript.parentNode.insertBefore(script, firstScript);})();</script>

3. In the JavaScript snippet, modify the JavaScript variables listed below to reflect your environment



and needs.

fireflyChatAPI.token

The API token for your chat server. This value is pre-populated in the snippet that you receive.

Note: This value is not the same as the server configuration key that you identify when you configure your chat server.

fireflyChatAPI.cobrowseAPIKey

For more information about how to obtain that key, see the Pega Co-Browse Implementation Guide on the Pega Customer Service product page.

fireflyChatAPI.queue

The chat queue for this web site. If this variable is defined, then Pega Chat ignores the fireflyChatAPI.skipQueueSelection variable.

If this variable is not defined, Pega Chat determines the queue selection based on the following criteria.

l If the fireflyChatAPI.skipQueueSelection variable is not defined or is set to false, the chat window presents a list of queues for the user to select from, or uses the default queue if only one queue is defined.

l If the fireflyChatAPI.skipQueueSelection variable is set to true, then Pega Chat uses URL mappings to assign a chat queue for this site.

fireflyChatAPI.skipQueueSelection

This variable is considered only when the fireflyChatAPI.queue variable is not defined. Set this variable to false if the chat window uses URL mappings to determine the queue selection. Set this variable to true if the chat window presents a list of queues for the user to select from, or use the default queue if only one queue is defined.

fireflyChatAPI.assetHostUrl

The URL from which Pega Chat loads assets (images and stylesheets). This value is pre-populated in the snippet that you receive, and is typically set to https://firefly-chat-production.s3.amazonaws.com.

fireflyChatAPI.serverHostUrl

The URL of the Pega Chat server. This value is pre-populated in the welcome email that you receive for a Pega Cloud Collaboration Services installation.




4. To pre-populate a pre-chat answer for your website, update the JavaScript snippet to include a statement in the format shown below.

fireflyChatAPI.preChatAnswers = {"username" : “Sara Connor”, "Account":1234560000, "ContactId":CONNOR, "Verified":"True"};

For each value pair, the first part of the value identifies the pre-chat key, and the second value identifies the answer. If an answer is pre-populated, then the pre-chat question associated with that answer is not asked.

Configuring co-browse in Pega ChatBy using Pega Co-Browse, a customer service representative can connect to customers' browsers and show them sections of the website by highlighting different elements of the web page. The customer service representative can also click links or fill out forms remotely without additional plug-ins or software.

1. In the Designer Studio Explorer panel, go to Records > SysAdmin > Dynamic System Settings.

2. Obtain the Pega Co-Browse API key, API token, CobrowseServerURL, CobrowseAssetURL, CobrowseloaderURL, and CobrowseSessionGenerationURL.

For more information on how to obtain these values, see the Pega Co-Browse Implementation Guide on the Pega Customer Service product page.

3. In the search field, enter and select the CobrowseAPIKey.

4. In the CobrowseAPIKey (Internal) page, in the Value field, enter the Cobrowse API key from the JavaScript snippet that you received.

5. Click Save.

6. Repeat steps 3 to 5 for CobrowseToken, CobrowseServerURL, CobrowseAssetURL, CobrowseLoaderURL, and CobrowseSessionGenerationURL. In the relevant pages, enter the cobrowse token, cobrowse server host URL, cobrowse asset URL, cobrowse loader URL, and cobrowse session generation URL.

Enabling automatic Pega Chat loginA CSR or manager has the option to automatically log in to Pega Chat when they log in to the Interaction Portal.




1. Log in to the Interaction Portal as an agent.

2. Click Operator > Preferences.

3. Click Desktop Preferences > Channels > Chat.

4. Select the Enable Chat check box.

5. In the Chat login preference list, select Save Login Info.

6. Select the Chat server to use.

7. In the Chat Display Name field, enter the name that will identify you to customers during a chat session.

8. Click Save Preferences.



Testing, packaging, and maintaining Pega Chat During the Delivery phase, complete the following tasks to test, package, and maintain Pega Chat.

1. Test the component

Test Pega Chat during product integration testing. For details, see Testing a new application.

2. Package and export the component

For information about how to package and export an application that includes Pega Chat, see Packaging a new application.

3. Production monitoring

Production monitoring for Pega Chat includes the following tasks.

l Synchronizing application updates with the chat server

l Monitoring chat queues

For complete information about production maintenance and monitoring tasks for Pega Customer Service for Healthcare, see Production maintenance and monitoring.

Synchronizing application updates with the chat serverWhenever you make changes in Designer Studio that affect Pega Chat (for example, modifying the chat server or adding chat skills to an operator record), the data must be synchronized with the chat server. This synchronization happens automatically any time you save changes to a chat server configuration (for example, when you add a new queue for a chat server). However, this synchronization must be performed manually for other changes, such as the addition of operator skills or a change to a calendar.

Note: Because synchronization is resource intensive in environments with a large number of users and chat skills, it is recommended that you perform synchronization off-hours.

1. Click Designer Studio > Channel Services > Pega Chat > Administration and Configuration.

The Chat Sync Status column shows the status of the server's most recent synchronization.



l Succeeded - The synchronization was successful.

l Failed - The synchronization was not successful. The Failed link shows information about why the failure occurred.

2. Select the chat server.

3. Click the Options icon , and then click Synchronize.

Note: An alternative method is to modify the agent schedule for the Pega-provided agents rule (ruleset PegaFW-Chat). That rule runs periodically to ensure that the configuration is kept synchronized.

Monitoring chat queuesMonitor the real-time performance of chat queues to ensure that you are delivering the expected levels of service.

Monitoring chat queues from the Interaction Portal

1. From the dashboard of the Interaction Portal, click the Switch to edit mode icon .

2. Click Add Widget(s).

3. In the CHAT section, select Monitor Chat Queues, and then click Add selected at the bottom of the widget page.

4. Click Publish.

5. Select the chat server.

Monitoring chat queues from Designer Studio 1. Click Designer Studio > Channel Services > Pega Chat > Administration &

Configuration. The Administration and Configuration landing page opens.

2. Select the chat server that you want to monitor, click the Options icon , and then click Monitor.

Chat queue statistics

The Chat queue monitor shows the following real-time statistics for the selected chat queue.



Open?

Whether the chat queue is currently open, based on the hours of operation. Only the widget shows this value.

Queue

Name of the queue.

Requests

The number of customer requests currently waiting to be served.

Estimated Wait Time (sec)

The amount of time (in seconds) a new customer joining the queue is likely to have to wait before they are served.

Logged in Agents / Operators

The number of operators logged in and skilled to serve requests in this queue.

Longest Wait Time (sec)

The longest wait time (in seconds) currently being experienced by a customer who is in the queue.



Pega Social configuration Pega Customer Service helps global service teams deliver relevant, fast customer experiences using social channels. To enhance social Customer Service Representative's (CSR) productivity, Pega uses advanced text analytics to cut through social media noise and extract only those conversations that are relevant. Pega guides your CSR through every social interaction by analyzing sentiment, topics and influence scores so that your teams can adapt and execute the best service strategy. CSR can take advantage of interaction histories across service channels, as well as Pega Knowledge and Case Management tools, to deliver a satisfying response to customers.

Pega Social includes features that use the Text Analytics and Natural Language Processing features of the Pega Platform. You may use Text Analytics and Natural Language Processing features solely with the application unless you have licensed these features separately for other purposes. Contact your Pega account executive if you require a license to use the Text Analytics and Natural Language Processing features for other purposes.

Pega Social implementation includes the following processes.

• Defining requirements for the Pega Social configuration

• Building Pega Social functionality

• Monitoring Pega Social

Defining requirements for the Pega Social configuration During the Define phase, complete the following tasks:

• Compiling a list of business Twitter handles and Facebook business pages

• Defining and registering Facebook and Twitter applications

• Defining operators, access groups, work groups, and workbaskets


Pega Social configuration

Compiling a list of business Twitter handles and Facebook business pagesWith Pega Social, you can receive tweets and posts from social channels such as Twitter and Facebook and respond to them.

To compile a list of business Twitter handles, remember the following points l Your business may have branded one or more Twitter accounts for customer service.

l Your customers may contact you through one of your Twitter accounts. You can route their queries to the right team. Compile a list of all Twitter accounts that you need to monitor.

l You can respond to incoming tweets from either a single or multiple outgoing Twitter handles.

l The administrator maps incoming Twitter handles to the outgoing Twitter handles. For example, for the incoming Twitter handle @askmybank, you can set the outgoing Twitter handle @mybank to respond to the customers.

To compile a list of Facebook business pages, remember the following points l Compile a list of your business Facebook page URLs, from where you intend to provide customer

service. If your business does not have a Facebook page, create one using your business profile.

l Your administrator configures listening and response capabilities for your Facebook business pages.

To record your decisions during this procedure, use the "Compile Twitter handles and Facebook pages" worksheets in the Implementation Planning Workbook.

Defining and registering Facebook and Twitter applicationsPega Customer Service uses publicly available APIs from Twitter and Facebook to harvest social messages and posts. These messages and posts are subject to the limitations of Facebook and Twitter for accuracy, completeness, and availability. Further, they are subject to versioning and stability of their APIs.



Note: Pega does not warrant the accuracy, completeness, and availability of any third-party content. Use of this data by Pega or its customers is subject to the terms of services of Facebook and Twitter. For more information about Facebook and Twitter terms of services, see their websites.

Before you create your Twitter and Facebook applications, consider the following points.

l The number of connectors that you want to create. A connector enables API connectivity to Twitter.

l The number of dedicated Twitter applications. It is recommended that you have a dedicated Twitter application for each connector because reusing Twitter application tokens across multiple connectors will likely result in API rate-limiting issues by Twitter.

l Ensure that you have a dedicated Twitter application for incoming tweets and messages.

l Facebook API tokens can be reused across connectors.

Ensure that you create and register applications with Twitter and Facebook. Creating and registering a Facebook application is a time-consuming process. This process might take 3-7 days for a new application approval. For detailed information about the registration process, see the Facebook website.

Creating and registering a Facebook application

1. Log in to your Facebook developer account.

2. In the My Apps list, click Add a New App.

3. On the Add a New App menu, click Facebook Canvas.

4. Complete the form to create the application.

5. Ensure that you request the following access credentials:

l publish_pages

l read_page_mailboxes

l manage_pages

6. Follow the steps in the Quick start wizard to complete the registration process.

7. Submit your application for review.



Creating and registering a Twitter application

1. Log in to your Twitter developer account.

2. Click Create New App.

3. Complete the Create an application form.

Ensure that a proper callback URL is provided otherwise response authorization issues will occur.

4. Select the Yes, I agree check box to agree to the developer agreement.

5. Click Create your Twitter application.

6. Click the Keys and Access Tokens tab.

7. To create access tokens, click Create my access tokens. With an access token, you can make API calls. The access token is generated with the default read permission.

8. To test the oAuth tokens, click Test oAuth. The oAuth tool page shows the configuration details for the Twitter connector.

Defining operators, access groups, work groups, and workbasketsPega Customer Service ships many operators, access groups, work groups, and workbaskets. To view them, perform the following steps.


2. Click Designer Studio > Application > Structure > Access Groups and Users.

Building Pega Social functionalityDuring the Delivery phase, follow these steps to configure Pega Social functionality.

• Updating the GetOpenSocialCasesFromWorkList report definition for your application

• Configuring social streams

• Configuring Twitter and Facebook connectors

• Configuring wrap-up reason codes for social interactions

• Configuring social queues



• Defining topics

• Enabling customer service representatives to respond to social messages

• Authorizing customer service representatives on social channels

• Setting up an email account

• Enabling the social agents

• Attaching Facebook images

• Configuring the social settings

Updating the GetOpenSocialCasesFromWorkList report definition for your applicationTo implement Pega Social in your Pega Customer Service, modify a report definition to point to the social class in your implementation.

1. Log in to Designer Studio by entering your administrator credentials and the password that you specified.

2. In Designer Studio, search for and select the GetOpenSocialCasesFromWorkList report definition.

3. Click Save as to save this rule to your implementation ruleset.

4. Click the Data Access tab.

5. In the Class joins section, in the Class name field, update the class name to the social class name in your implementation.

Configuring social streamsA social stream is a logical container that stores harvested social messages such as tweets and posts. It is also used to store associated connectors, topics, and taxonomy. Your implementation may require more than one social stream. For example, your implementation may store all tweets and Facebook posts that belong to the European market in one social stream and the Asia-pacific market in another social stream.

Pega Social provides a sample social stream.

Complete the following steps to configure a social stream from the sample stream.




2. In the search field, enter and select CSSocialSampleSocialstreamTemplate.

3. Click Save as to save this data flow in an open ruleset.

To know more about data flow, see Data Flow service.

Configuring Twitter and Facebook connectors A connector is implemented through a combination of a data set and a data flow. (To learn more about data sets and data flows, see About Data Set rules and About Data Flow rules).

1. Complete the following steps to configure a Twitter data set.

a. Log in to Designer Studio.

b. In the search field, enter and select CSSocialSampleTwitterDataset.

c. Click Save as to save this in your open ruleset.

d. Enter the API tokens of the Twitter application that you want to use.

e. Optional: Enter the Klout API token.

Note: To harvest Klout scores for all Twitter users, you need to enter the Klout API key. If you have not registered with Klout for API access, you can register at the Klout website.

f. Click Save and check-in the data set.

2. Complete the following steps to configure a Twitter data flow.


b. In the search field, enter and select CSSocialSampleTWConnector.


d. Configure the Twitter data set that you have created in step 1 as the source of this data flow.

e. Configure the target of this data flow with the social stream in which you would like to store the data.

3. Complete the following steps to configure a Facebook data set.



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b. In the search field, enter and select CSSocialSampleFBDataset.


d. Enter the API tokens of the Facebook application.

e. Optional: Enter the Klout API token.

4. Complete the following steps to configure a Facebook data flow.


b. In the search filed, enter and select CSSocialSampleFBConnector.

c. Click Save as to save this ruleset.

d. Configure the Facebook data set that you created in step 3 as the source of this data flow.

e. Configure the target of this data flow with the social stream in which you would like to store the data.

5. Complete the following steps to start a connector.

a. In Designer Studio, click Designer Studio > Channel Services > Pega Social.

b. In the Social stream list, select your social stream to view the list of connectors.

c. Click Start to initiate the connector data flow.

Configuring wrap-up reason codes for social interactionsWhen CSRs resolve or dismiss a Pega Social interaction, they assign it a wrap-up reason code.

The application includes many preconfigured reason codes to resolve or dismiss a social interaction.

Adding or modifying the wrap-up reason code - resolved, for social interactions.


2. In the search field, enter GetWrapupReasons, and then click the Search icon .

3. Select the GetWrapupReasons data transform from the result list.



4. Click Save as.

5. In the Add to ruleset list, select a ruleset, and then click Create and open.

The application provides several pre-configured resolved reason codes for the social interaction (for example, Account maintenance) that are assigned to a case when it is resolved.

6. In the Source list change these reasons for social interaction code (for example, change Account Maintenance to Branch Approval).

7. Copy and paste step 2.1 of data transform to add a new reason for social interaction code.

8. In the Source list, replace the copied reason for social interaction code with your own (for example, Branch setup).

Adding or modifying the wrap-up reason code - dismissed, for social interactions.

1. Repeat steps 1 through 4 from the above procedure.

2. The application provides several pre-configured dismissed reason codes for the social interaction (for example, Junk) that are assigned to a case when it is resolved.

3. In the Source list change these reasons for social interaction code (for example, change Junk to Noise).

4. Copy and paste step 3.1 of data transform to add a new reason for social interaction code.

5. In the Source list, replace the copied reason for social interaction code with your own (for example, Branch closure).

Configuring social queues Social queues create cases automatically based on pre-defined conditions for incoming social messages. A case can be assigned to a workbasket or to an operator’s worklist.

1. In Designer Studio, click Designer Studio > Channel Services > Pega Social.

2. Click the Social Queues tab, and then click the New icon to add a social queue.



3. On the General tab, fill in the Queue name and select a stream from the Associated stream list. Optional: you can select Start date and End date to define the queue for a particular period. A queue will not be active after the end date.

4. On the Conditions tab, select items from the Criteria list, Criteria Evaluator, and the Criteria Value lists. For example, Sentiment is negative.

5. On the Actions tab, select any value from the Assign to list, select the associated value of the selected item, and then select any item from the Assign SLA list. For example, select the Operator - CACSR and Assign SLA - NotifyManager.

6. Click Apply.

Defining topicsTopics are an optional set of keywords that describe a company, brand, department, line of business, or a subject of interest. They are ideal for filtering the data that is harvested from social websites. For example, an airline could set up topics such as “Corporate Customers”, “Travel Partners”, or “Mobile Check-in.”

Identify each keyword that you plan to use to filter harvested data.

Enabling customer service representatives to respond to social messages Your customer service representatives can respond to customer issues through tweets from a single or multiple Twitter handles. The administrator maps incoming Twitter handles to outgoing Twitter handles.

For example, tweets received from the incoming Twitter handle @corporatehandle can be set up to respond as either @corporatehandle or @askcustomercare (assuming both handles are owned and configured by your organization).

Follow these steps to configure outgoing Twitter handles.

1. In Designer Studio, click Designer Studio > Channel Services > Pega Social > Response Authorizations.

2. On the Twitter tab, in the Handle mappings section, click New to add a twitter handle.



a. In the Listening handle field, enter an incoming Twitter handle for example, @corporatehandle

b. In the Response handle field, enter an outgoing Twitter handle for example, @askcustomercare

c. In the Numeric ID field, enter the corresponding numeric ID.

Each handle has two mappings: one to map to itself to listen and response another that maps to default handle as described in Configuring the social settings. Using two mappings, customer service representatives can respond to customers using handles other than the default handle.

3. In the Response configuration section, complete the following steps.

a. in the Create OAuth profile for list, click a Twitter handle

b. in the OAuth consumer key field, enter the OAuth consumer key from Twitter

c. in the OAuth shared secret key field, enter the OAuth shared secret key from Twitter

4. Click Create.

Note: You can find the ID for your Twitter handles using any third-party tools, for example idfromuser.

Authorizing customer service representatives on social channelsYou must authorize Customer Service Representatives (CSRs) to respond to customer tweets and posts from the Customer Service Interaction portal.

Authorizing CSRs on Twitter 1. Log in to the Customer Service Interaction Portal, and then click Operator > Preferences.

2. Under the Social (Authorization) group, click Twitter.

3. In the OAuth Profile list, select the profile that you want to authorize this user.

4. Click Authorize. The Twitter window is displayed.



5. Enter text into User Name and Password fields.

6. Click Save.

Authorizing CSRs on Facebook 1. Log in to your Facebook developer account.

2. On the Facebook developer homepage, in the My Apps list, select your application.

3. On the application page, click Settings.

4. On the Basic tab, enter details in the Secure Canvas URL and Site URL fields.

5. Log in to the Customer Service Interaction Portal, and then click Operator > Preferences.

6. Under the Social (Authorization) group, click Facebook. The Application ID and Application Secret of the application that you selected are populated automatically from the Facebook application.

7. Click Authorize, and then enter the access credentials in your Facebook window. Facebook automatically retrieves access tokens and page tokens for all your authorized Facebook business accounts.

8. Click Save.

Note: To respond, administrators must authorize themselves on the Facebook before CSRs authorize themselves.

Setting up an email account An administrator sets up an email account to send a complete social interaction conversation history to another CSR, or to a client.

To set up an email account for work pool, see Email Account form – Completing the Email Account.

Enabling the social agentsAn agent is an internal background process operating on a server that performs activities on a periodic basis. To create a social case from social messages or to append a post from social channels



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to an existing social case, you must configure the Process Threaded Documents, the Auto Create Cases, and the Notify on DF Status Change agents.

The Process Threaded Documents agent appends a new post or message to an existing case in the database. For example, when a customer posts a message on Facebook or Twitter, if this post belongs to an existing case, then this post is appended to that case. This agent must be running so that the posts that belong to the existing case are appended.

The Auto Create Cases agent creates new cases in the database. For example, when a customer posts a message on Facebook or Twitter, if this post does not belong to an existing case, then a new case is created for this post. This agent must be running so that new cases are created.

The Notify on DF Status Change agent sends an email notification when the status of a social connector changes from Stopped to In Progress, and from In Progress to Fail or Stop. The recipients of these notifications are defined in GroupEmailId in Configuring the social settings.

For more information on agents, see Agent Management in System Operations landing page.

To enable the social agents, perform the following tasks:

1. Log in to Designer Studio by entering your administrator credentials.

2. Go to System > Operations > Agent Management.

3. Filter the Ruleset column to display the rules for your application implementation's ruleset, and then perform the following steps:

a. To append a new post to an existing case, select the Process Threaded Documents agent.

b. To create a new case, select the Auto Create Cases agent.

c. To send email notifications when social connector status changes, select the Notify on DF Status Change agent.

4. Click Start.

Note: In a multi-node environment, by default these agents run on one node at a time. Do not change this default setting.

5. When any of these agent stops, start it by repeating these steps.



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Attaching Facebook imagesYou can attach images posted by customers to the Facebook messages so that the Customer Service Representative (CSR) understands the context of the messages quickly.

1. In Designer Studio, in the search field, enter SampleFBDefinition, and then click the search icon.

2. Select the SampleFBDefinition data instance from the result list.

3. Copy the values from the application ID, application secret, and then access token fields to a separate text file for easy access.

4. Click Designer Studio > Decisioning > Infrastructure > Social media Metadata > Facebook.

5. Enter the copied application ID into App ID, and application secret into App secret.

6. In the Facebook page URL field, enter the URL of the web page that you want to monitor (for example, https://www.facebook.com/pegasystems).

7. On the Message tab, complete the following steps.

a. In the Facebook page token field, enter the page access token that you copied earlier.

b. In the Facebook message query field, enter your query for the information that you need (for example, id,snippet,updated_time,message_count,participants{name,email,id,picture},messages{id,from,message,created_time,tags,to,attachments,shares}).

8. Click Retrieve metadata.

The Generate message query field shows the query generated from the metadata.

9. In the Metadata mapping section, follow these steps.

a. Click Add mapping.

b. In the Source field column, enter the source, and in the Target field column, enter the target as shown below

Source Target



message.attachments.{o}imageData.previewUrl mapping

.FBMediaURL

message.attachments.{o}videoData.previewUrl mapping

.FBMediaURL2

message.shares.{o}.link .FBMediaURL

message.attachments.{o}videoData.Url .VideoURL

10. Click Save.

11. On the Post tab, in the Facebook post query field, enter your values (for example, attachments, source).


The Generate post query field shows the post query generated from metadata.



b. In the Source field column, enter your source (for example, message.attachments.(0).imageData.previewUrl mapping), and then in the Target field column, enter your target (for example, .FBMediaURL).

14. Click Save.

15. On the Comment tab, in the Facebook comment query field, enter your values (for example, attachments).


The Generate comment query field shows the comment query generated from metadata.



b. In the Source field column, enter your source (for example, attachment.media.image.src), and then in the Target field column, enter your target (for example, .FBMediaURL).

18. Click Save.



Configuring the social settingsAn administrator configures different settings for the customer service representative. Based on these settings, the customer service representative can view the number of cases that are resolved during a specified time period, the total number of posts from different social channels, and email IDs to receive error messages when a social connector fails.

1. Log in to Designer Studio by entering your credentials.

2. In the search field, enter and select SocialSettings map value.

3. Click Save as, in the Label field, enter the name, and then click Create and open.

4. To change the time of a system thread from a customer's new post in to an existing social case if the number of days between the new post and the most recent post in the case is less than the threshold value, in the Response field of the ="Threshold Value" row, specify the value in minutes, for example, 20.

5. To change the cases that a customer service representative can see, in the Response field of the =”ResolvedCasesTimeFrame” row, enter the number of days that you want the cases to be displayed (for example, 10).

6. To receive the alert emails when a social connector fails, in the Response field of the ="GroupEmailId" row, enter the comma separated email IDs. For more information on connectors, see Monitoring connectors.

7. A customer service representative can use the outgoing Twitter handles that are configured to reply to tweets. In addition to the outgoing Twitter handles, you can also add a default outgoing handle. To add a default outgoing handle, in the Response field of the ="DefaultTwitterHandle" row, enter a Twitter handle, for example, @MyBank. For more information on Twitter handles, see Configuring social streams.

8. Customer service representatives can pull in social interactions to respond by clicking social cases icon in the application bar, and select the next most urgent social case to address. By default, customer service representatives can see the Facebook and the Twitter messages together. To view two icons in the application bar, one for the Facebook and one for the Twitter, in the Response field of the ="SocialChannelAggregate" row, enter false.

9. To run the Notify on DF Status Change agent from the implementation ruleset, in the Response field of the ="Social Standard Agent RuleSet" row, enter your implementation ruleset.

10. Save the changes.



Monitoring Pega SocialMonitoring Pega Social includes the following tasks:

l Monitoring connectors

l Monitoring agents

l Monitoring social channel operations performance

For additional information about monitoring tasks for Pega Customer Service for Healthcare, see Production maintenance and monitoring.

Monitoring connectorsA connector is a Pega Platform programmatic component that defines and implements an interface between a Pega Platform application that is acting as a client, and an external system that is acting as a server.

To display the in-progress status for a connector, follow these steps.

1. In Designer Studio, click Designer Studio > Channel Services > Pega Social.

2. On the Connectors tab, select a social stream from the Select a social stream list.

3. In the Available Connectors section, click Start on the connector that you want to monitor.

4. Expand the Performance section by clicking >.

Monitoring agentsAn agent is an internal background process operating on the server that runs activities on a periodic basis.

To monitor the Process Threaded Documents, Auto Create Cases, and Notify on DF Status Change agents created in the implementation application, see Enabling the social agents.

Monitoring social channel operations performanceYou can monitor and measure the operational performance of Twitter and Facebook social channels.



l Facebook SLA compliance metrics - This dashboard widget shows the number of open cases, number of cases that meet SLAs, and number of cases that have past goals and deadlines on Facebook channel.

l Twitter SLA compliance metrics - This dashboard widget shows the number of open cases, number of cases that meet SLAs, and number of cases that have past goals and deadlines on Twitter channel.

l Topic Social Topics - This dashboard widget shows the topics detected in incoming Tweets and Facebook posts and their corresponding sentiment split - positive, negative or neutral.

l Social Language Volume - This dashboard widget shows count of Tweets and Facebook posts in different languages.

Complete the following steps to monitor social channels.

1. Log in to the Customer Service Interaction Portal.

2. Click the Personalize home screen icon .

3. In the Edit Dashboard layout, click Switch template.

4. Select any template, and then click Add widgets.

5. Go to the Social Interactions, select any number of widgets, and then click Add selected.

Note: Widgets are optimized to look better in particular slot sizes. They are not designed to be responsive in all slot sizes. Place them in slots where they render well.

6. In the Edit Dashboard layout, click Publish.

